Jonathan Azizzadeh, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Los Angeles, CA
NPI 1215949367 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1215949367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- A52711 (CA)
- Practice address
- 1300 N Vermont Ave
Los Angeles, CA 90027-6005 - Phone
- (323) 906-0000
- Fax
- (323) 953-6300
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040308001318 | CA | Practitioner - Obstetrics/Gynecology | 0547158818 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A52711 | CA | MD | Obstetrics & Gynecology Physician |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cha Hollywood Medical Center, LP | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jonathan.azizzadehmd.p1@direct.jwch.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A52711 | CA | Yes |
Addresses
Primary practice location
1300 N Vermont Ave
Los Angeles, CA 90027-6005
Mailing address
339 N Oakhurst Dr
Suite 101
Beverly Hills, CA 90210-4183
Phone (323) 906-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A527110 | Medicaid | CA |
Other providers in Los Angeles, CA
- Najwa Azizi
- Haik Tahmaseb Azizian
- Afshin Azizisefat
- Avetis Azizyan
- Aylin Azizyans
- Lea Azour
- Samantha Azriel
- Ugochi Onuchi Azubuike
- Mercy Ekeoma Azubuko-Udah
- Daniel Orlando Azucar
All providers in Los Angeles, CA · Obstetrics & Gynecology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.