Individual provider Active NPI

Parviz Akhavan, D.O

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1235286436
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A7522 Issued in CA
Practice address
723 E Manchester Ave
Los Angeles, CA 90001-3632
Phone
(323) 750-2325
NPI assigned
Jan 3, 2007
Last updated
Jan 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A7522 CA Primary

Addresses

Primary practice location

723 E Manchester Ave
Los Angeles, CA 90001-3632

Mailing address

540 N San Jacinto St
Ste P
Hemet, CA 92543-3154
Phone (323) 750-2325

Other identifiers 1

IdentifierTypeStateIssuer
00AX75220MedicaidCA

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
I20101006000818 CA Practitioner - Family Practice 0042288508 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7522CAMDGeneral Practice Physician
7522CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Community Healthcare Center CurrentSince Jan 18, 2022 Accepting new patients
Tri-State Community Healthcare Center CurrentSince Jan 18, 2022 Accepting new patients
Neighbor Hood Medical Clinic Current Accepting new patients
Tri-State Community Healthcare Center Current Accepting new patients

Locations

11888 Bartlett Ave
Adelanto, CA 92301
Phone (760) 530-9944

540 N San Jacinto St
Hemet, CA 92543
Phone (951) 492-0728

540 N San Jacinto St
Ste P
Hemet, CA 92543
Phone (951) 651-1006

723 E Manchester Ave
Los Angeles, CA 90001
Phone (323) 750-2325

820 W Broadway St
Needles, CA 92363
Phone (760) 326-0222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: parviz.akhavan.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1235286436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N SAN JACINTO ST",
            "address_2": "STE P",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433154",
            "telephone_number": "323-750-2325",
            "fax_number": "323-750-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 E MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013632",
            "telephone_number": "323-750-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHAVAN",
        "first_name": "PARVIZ",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A7522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX75220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.