Omid Modarres Mousavi, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

A121076 Issued in CA

Practice address

12130 Paramount Blvd
Downey, CA 90242-2339

Phone

(323) 889-7830

NPI assigned

May 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memory and Movement Clinic

  • Geriatric Medicine (Family Medicine) Physician
  • Newport Beach, CA
  • NPI 1447139175
  Medicare reassignment NPD

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1043444029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR STE 303",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422339",
            "telephone_number": "323-889-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSAVI",
        "first_name": "OMID",
        "middle_name": "MODARRES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A121076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brijenee Trynise Morse
• Jacqueline Mosqueda
• Sabrina Mottola, RD
• Bhaswati Moulik, DDS
• Mourad Corporation
• Marina Moussa
• Cara Moyer
• Adonna Moyher, RN
• Mari Muki, LCSW
• Girisha Mulhearn, DO

• Geriatric Medicine (Family Medicine) Physician in Downey, CA
• Providers in Downey, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.