Individual provider Active NPI

Malek Mazzawi, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Los Angeles, CA
National Provider Identifier
1124478391
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
A187572 Issued in CA
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(508) 577-6788
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X A187572 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd # 113
Los Angeles, CA 90027-6062
Phone (323) 361-6522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200619000844 DC Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 2062708985 Reassigns benefits to 1 organization
I20230807001803 CA Practitioner - Emergency Medicine 2062708985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Massachusetts Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Los Angeles Medical Group IncGroup PAC ID 0143126920, 288 clinicians

Practice addresses (Care Compare)

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A187572CAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatrics CurrentSince Jun 16, 2020 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jul 1, 2023 Accepting new patients
Children'S Hospital CurrentSince Jun 16, 2020 Accepting new patients
Children'S Hospital Current Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients
Children'S Hospital Los Angeles Past Accepting new patients
Tufts Medical Center Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients

Locations

4650 W Sunset Blvd
#113
Los Angeles, CA 90027
Phone (323) 361-2109

4650 W Sunset Blvd
#87
Los Angeles, CA 90027

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1124478391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 113",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "508-577-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAWI",
        "first_name": "MALEK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A187572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.