Individual provider Active NPI

Milena Shakhbazova, M.D.

  • Family Medicine Physician
  • Torrance, CA
National Provider Identifier
1043494313
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A104972 Issued in CA
Practice address
3333 Skypark Dr
Suite 100
Torrance, CA 90505-5023
Phone
(310) 784-6300
Fax
(310) 784-6313
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A104972 CA Primary

Addresses

Primary practice location

3333 Skypark Dr
Suite 100
Torrance, CA 90505-5023

Mailing address

3333 Skypark Dr
Ste.100
Torrance, CA 90505-5023
Phone (310) 784-6300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091229000382 CA Practitioner - Family Practice 7517007339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

3333 Skypark Dr
Suite 100
Torrance, CA 90505-5034
Phone (310) 784-6300

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A104972CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

3333 Skypark Dr
Ste 100
Torrance, CA 90505
Phone (310) 784-6300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1043494313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 SKYPARK DR",
            "address_2": "STE.100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055023",
            "telephone_number": "310-784-6300",
            "fax_number": "310-784-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SKYPARK DR",
            "address_2": "SUITE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055023",
            "telephone_number": "310-784-6300",
            "fax_number": "310-784-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKHBAZOVA",
        "first_name": "MILENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A104972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.