Active NPI
Mirwais Mohammad, MD
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1194427237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 13293
- Practice address
- 4211 Avalon Blvd
Los Angeles, CA 90011-5622 - Phone
- (323) 563-4800
- NPI assigned
- Mar 21, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 13293 | CA | Primary |
Addresses
Primary practice location
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Mailing address
4211 Avalon Blvd
Los Angeles, CA 90011-5622
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13293 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715904000000",
"number": "1194427237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 AVALON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 AVALON BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900115622",
"telephone_number": "323-563-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMMAD",
"first_name": "MIRWAIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-21",
"last_updated": "2024-05-17",
"certification_date": "2024-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "13293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Mohammad Ashori MD Inc
- Mohammad Hussain Psychiatric Mental Health Nurse Practitioner Nursing Services Corporation
- Mohammad Khalifeh, DDS, Inc.
- Haneen Mohammad Saeed, PHARMD
- Esroruleh Tamim Mohammad, PHD
- Sharif Mohammad, DDS
- Tareq Mohammad, MB BCH
- Nava Mohammadi, DPM
- Amir Ali Mohammadzadeh, MD
- Linha Mazin Mohammed, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.