Organization Active NPI

Hayvenhurst Infectious Dis. Inc.

  • Infectious Disease Physician
  • Encino, CA
National Provider Identifier
1043236458
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A65901 Issued in CA
Legal business name
HAYVENHURST INFECTIOUS DIS. INC.
Practice address
4054 Strawberry PL
Encino, CA 91436-3826
Phone
(310) 914-9150
Fax
(310) 914-9705
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Alan Nazarian, MDNPI 1831126739
Title
Medical Doctor
Phone
(310) 914-9150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X A65901 CA Primary

Addresses

Primary practice location

4054 Strawberry PL
Encino, CA 91436-3826

Mailing address

4054 Strawberry PL
Encino, CA 91436-3826
Phone (310) 914-9150

Other identifiers 1

IdentifierTypeStateIssuer
00A659010MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060316000576 CA Part B Supplier - Clinic/Group Practice 0345257283 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

5525 Etiwanda Ave
Ste 302
Tarzana, CA 91356
Phone (818) 783-8963

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043236458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 STRAWBERRY PL",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363826",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 STRAWBERRY PL",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363826",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYVENHURST INFECTIOUS DIS. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAZARIAN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "310-914-9150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A65901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A659010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.