Individual provider Active NPI

Kamran K Kamrava, MD

  • General Practice Physician
  • Reseda, CA
National Provider Identifier
1053483800
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A43281 Issued in CA
Practice address
6915 Reseda Blvd
Suite 1
Reseda, CA 91335
Phone
(818) 343-2121
Fax
(818) 705-1622
NPI assigned
Nov 15, 2006
Last updated
Dec 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A43281 CA Primary

Addresses

Primary practice location

6915 Reseda Blvd
Suite 1
Reseda, CA 91335

Mailing address

6915 Reseda Blvd
Suite 1
Reseda, CA 91335
Phone (818) 343-2121

Other identifiers 1

IdentifierTypeStateIssuer
00A432810MedicaidCA

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
I20110105001186 CA Practitioner - General Practice 8527257690 Reassigns benefits to 2 organizations
Practice locations: Reseda, CA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prowellness Healthcare IncGroup PAC ID 3870027220, 4 clinicians
Doctors on the Go Inc.Group PAC ID 6002296308, 4 clinicians

Practice addresses (Care Compare)

425 E Colorado St
Glendale, CA 91205-5117
Phone (818) 532-2222

6915 Reseda Blvd
Reseda, CA 91335-4214
Phone (818) 343-2121

8439 White Oak Ave
Suite 103
Rancho Cucamonga, CA 91730-3860
Phone (818) 337-6488

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A43281CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prowellness Healthcare Inc. CurrentSince Feb 10, 2025 Accepting new patients
Doctors on the Go Inc. CurrentSince Feb 10, 2025 Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients

Locations

425 E Colorado St
Ste 535A
Glendale, CA 91205
Phone (818) 532-2222

8439 White Oak Ave
Ste 103
Rancho Cucamonga, CA 91730
Phone (818) 337-6488

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

Hospital & facility affiliations 7

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1053483800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 RESEDA BLVD",
            "address_2": "SUITE 1",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-343-2121",
            "fax_number": "818-705-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 RESEDA BLVD",
            "address_2": "SUITE 1",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-343-2121",
            "fax_number": "818-705-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMRAVA",
        "first_name": "KAMRAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A43281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A432810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.