Active NPI
Gabrielle Ahlzadeh, MD
- Emergency Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- A169081
- Practice address
- 1225 Wilshire Blvd
Los Angeles, CA 90017-1901 - Phone
- (213) 977-2121
- NPI assigned
- Jan 15, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125066385 | IL | |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 11209646-1205 | UT | |
| Emergency Medicine Physician | 207P00000X | A169081 | CA | Primary |
Addresses
Primary practice location
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-2121
Other practice location 1
251 E Huron St
Chicago, IL 60611-2908
Phone (312) 926-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Northwestern University Feinberg Medical School, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1011 Balwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A169081 | CA | MD | Emergency Medicine Physician |
| 11209646-1205 | UT | MD | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000
1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849
1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005
Organizations & group practices 6
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1427937390
-
- Otolaryngology Physician
- Salt Lake City, UT
- NPI 1003210808
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baldwin Park, CA
- NPI 1477608271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1225427172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "213-977-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171901",
"telephone_number": "213-977-2121"
}
],
"practiceLocations": [
{
"address_1": "251 E Huron St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112908",
"country_code": "US",
"telephone_number": "312-926-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AHLZADEH",
"first_name": "GABRIELLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-15",
"last_updated": "2023-12-22",
"certification_date": "2021-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125066385",
"primary": false
},
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "UT",
"license": "11209646-1205",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A169081",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.