Individual provider Active NPI

Shirin Hejazi Yousefi, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1083902118
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14801TLG Issued in CA
Practice address
8635 W 3Rd St
#360W
Los Angeles, CA 90048-6101
Phone
(310) 657-2777
Fax
(310) 657-0356
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14801TLG CA Primary

Addresses

Primary practice location

8635 W 3Rd St
#360W
Los Angeles, CA 90048-6101

Mailing address

8635 W 3Rd St
#360W
Los Angeles, CA 90048-6101
Phone (310) 657-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7851TXMDChiropractor
14801TLGCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1083902118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "#360W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-657-2777",
            "fax_number": "310-657-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "#360W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-657-2777",
            "fax_number": "310-657-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFI",
        "first_name": "SHIRIN",
        "middle_name": "HEJAZI",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14801TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.