Individual provider Active NPI

Damir Makhanov

  • Massage Therapist
  • North Hollywood, CA
National Provider Identifier
1134908783
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
4444 Lankershim Blvd Ste 207
North Hollywood, CA 91602-2346
Phone
(818) 200-8296
NPI assigned
Sep 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

4444 Lankershim Blvd Ste 207
North Hollywood, CA 91602-2346

Mailing address

11851 Dehougne St
North Hollywood, CA 91605-6081
Phone (818) 200-8296

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1134908783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11851 DEHOUGNE ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916056081",
            "telephone_number": "818-200-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 LANKERSHIM BLVD STE 207",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022346",
            "telephone_number": "818-200-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHANOV",
        "first_name": "DAMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.