NPIMap

Organization Active NPI

Ebrahim Hazany MD a Medical Corporation

  • Adult Mental Health Clinic/Center
  • Newbury Park, CA
National Provider Identifier
1104929082
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
A53409 Issued in CA
Legal business name
EBRAHIM HAZANY MD A MEDICAL CORPORATION
Practice address
1000 Newbury Rd Ste 240
Newbury Park, CA 91320-6443
Phone
(805) 498-1400
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ebrahim Hazany, MDNPI 1346359304
Title
Owner
Phone
(805) 498-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X A53409 CA Primary

Addresses

Primary practice location

1000 Newbury Rd Ste 240
Newbury Park, CA 91320-6443

Mailing address

1000 Newbury Rd Ste 240
Newbury Park, CA 91320-6443
Phone (805) 498-1400

Other names 1

  • Cope Clinic Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000161 CA Part B Supplier - Clinic/Group Practice 2860590254 Receives reassigned benefits from 2 practitioners
Practice locations: Newbury Park, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104929082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 240",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206443",
            "telephone_number": "805-498-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NEWBURY RD STE 240",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206443",
            "telephone_number": "805-498-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBRAHIM HAZANY MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAZANY",
        "authorized_official_first_name": "EBRAHIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-498-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "A53409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cope Clinic Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newbury Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.