Mariam Fazel

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A178242 Issued in CA

Practice address

8700 Beverly Blvd Ste 5512
West Hollywood, CA 90048-1804

Phone

(310) 423-6325

Fax

(310) 423-4683

NPI assigned

Jul 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Merit-based Incentive Payment System (MIPS)

Final score

93.23 of 100Reported as group

Quality

77.83

Promoting interoperability

98

Improvement activities

40

Cost

71.17

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.

• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment NPD
• Inpatient Specialists of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1952792475
  Medicare reassignment NPD
• Kansal Inc

  dba Platinum Medical Group

  • Internal Medicine Physician
  • West Hollywood, CA
  • NPI 1043510183
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Cedars-Sinai Medical Center

  • Registered Dietitian
  • West Hollywood, CA
  • NPI 1083785489
  NPD (past)

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1073034799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD STE 5512",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-6325",
            "fax_number": "310-423-4683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4610 X Street",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95817",
            "country_code": "US",
            "telephone_number": "916-816-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZEL",
        "first_name": "MARIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A178242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Farzad, DDS
• Leah Michelle Baum Fast, MD
• Mike Fatula, MS, MFT
• Tashifa Fayyaz
• Faza Dietetics LLC
• Daniel Louis Fazzino, PA-C
• Robert Fellin, PHARM.D., BCPS
• Ava Y Feng, M.D.
• Daniel Fenton
• Pamela Ruth Fenton, M.D

• Internal Medicine Physician in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.