Organization Active NPI

Legacy Health Inc

  • Sports Medicine (Internal Medicine) Physician
  • Northridge, CA
National Provider Identifier
1144065236
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
Legal business name
LEGACY HEALTH INC
Practice address
18350 Roscoe Blvd Ste 218
Northridge, CA 91325-4153
Phone
(818) 620-2485
Fax
(818) 993-8158
NPI assigned
Jun 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Dr. Raahil Kajani, MDNPI 1780245985
Title
President
Phone
(818) 620-2485

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
Sports Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0010X Primary

Addresses

Primary practice location

18350 Roscoe Blvd Ste 218
Northridge, CA 91325-4153

Mailing address

18350 Roscoe Blvd Ste 218
Northridge, CA 91325-4153
Phone (818) 620-2485

Other identifiers 1

IdentifierTypeStateIssuer
1780245985OtherCANPI

National Provider Directory

National Provider Directory

Locations

18350 Roscoe Blvd
Ste 218
Northridge, CA 91325
Phone (818) 620-2485

Practitioners & affiliated clinicians

Practitioners 2

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": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1144065236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD STE 218",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254153",
            "telephone_number": "818-620-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD STE 218",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254153",
            "telephone_number": "818-620-2485",
            "fax_number": "818-993-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "KAJANI",
        "authorized_official_first_name": "RAAHIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-620-2485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780245985",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.