101 Family Medical Group,a Professional Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A85704 Issued in CA

Legal business name

101 FAMILY MEDICAL GROUP,A PROFESSIONAL CORP

Practice address

22030 Sherman Way Ste 101
Canoga Park, CA 91303-1844

Phone

(818) 312-9101

Fax

(818) 312-9100

NPI assigned

Sep 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Hessam Aazami, M.DNPI 1144299173

Title

Medical Director

Phone

(818) 312-9101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hessam Aazami, M.D.

  • General Practice Physician
  • Canoga Park, CA
  • NPI 1144299173
  Medicare reassignment Care Compare group NPD Authorized official
• Jamsheed Akhavan, MD

  • Pediatrics Physician
  • Canoga Park, CA
  • NPI 1073661807
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1252195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1174856348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 ROCKRIDGE TER",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071265",
            "telephone_number": "818-312-9101",
            "fax_number": "818-312-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22030 SHERMAN WAY STE 101",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031844",
            "telephone_number": "818-312-9101",
            "fax_number": "818-312-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "101 FAMILY MEDICAL GROUP,A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-06",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "AAZAMI",
        "authorized_official_first_name": "HESSAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-312-9101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A85704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.