Individual provider Active NPI

Salma Foroozan, PA-C

  • Physician Assistant
  • Brawley, CA
National Provider Identifier
1134420631
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21331 Issued in CA
Practice address
900 Main St
Brawley, CA 92227-2630
Phone
(760) 344-6471
Fax
(760) 344-8410
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21331 CA Primary

Addresses

Primary practice location

900 Main St
Brawley, CA 92227-2630

Mailing address

900 Main St
Brawley, CA 92227-2630
Phone (760) 344-6471

Other practice location 1

450 E Birch St
Calexico, CA 92231-2375
Phone (760) 768-6262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217002715 CA Practitioner - Physician Assistant 8224324660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21331CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo, Inc CurrentSince Sep 28, 2020 Accepting new patients
Clinicas de Salud del Pueblo Inc. CurrentSince Sep 28, 2020 Accepting new patients

Locations

900 Main St
Brawley, CA 92227
Phone (760) 344-6471

223 W Cole Blvd
Calexico, CA 92231
Phone (760) 357-2020

852 E Danenberg Dr
El Centro, CA 92243
Phone (760) 352-2257

Interoperability endpoints

  • Direct secure messaging: salma.foroozan.p1@direct.cdsdp.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1134420631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272630",
            "telephone_number": "760-344-6471",
            "fax_number": "760-344-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272630",
            "telephone_number": "760-344-6471",
            "fax_number": "760-344-8410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 E Birch St",
            "address_purpose": "LOCATION",
            "city": "Calexico",
            "state": "CA",
            "postal_code": "922312375",
            "country_code": "US",
            "telephone_number": "760-768-6262",
            "fax_number": "760-768-9206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOROOZAN",
        "first_name": "SALMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.