Individual provider Active NPI

Ethan Youssefzadeh, DO

  • Family Medicine Physician
  • Culver City, CA
National Provider Identifier
1144951260
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A21948 Issued in CA
Practice address
10100 Culver Blvd Ste a
Culver City, CA 90232-3174
Phone
(310) 423-3333
NPI assigned
Jun 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 20A21948 CA Primary

Addresses

Primary practice location

10100 Culver Blvd Ste a
Culver City, CA 90232-3174

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033-2414
Phone (323) 226-1100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812004365 CA Practitioner - Family Practice 8628417581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

10100 Culver Blvd
Suite E
Culver City, CA 90232-3174
Phone (310) 423-3333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Jul 28, 2025 Accepting new patients

Locations

10100 Culver Blvd
Ste A
Culver City, CA 90232
Phone (310) 423-3333

10100 Culver Blvd
Ste E
Culver City, CA 90232
Phone (310) 423-3333

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: eyoussefzadeh524609@direct.cshs.org

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1144951260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 CULVER BLVD STE A",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323174",
            "telephone_number": "310-423-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 E Cesar E Chavez Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900332414",
            "country_code": "US",
            "telephone_number": "323-226-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSSEFZADEH",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.