NPIMap

Organization Active NPI

Dr. Neevon C. Esmaili, MD, a Professional Corporation

Doing business as Mental Fitness Clinic Child, Adolescent & Adult Health

  • Child & Adolescent Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1245609627
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A115518 Issued in CA
Legal business name
DR. NEEVON C. ESMAILI, MD, A PROFESSIONAL CORPORATION
Doing business as
Mental Fitness Clinic Child, Adolescent & Adult Health
Practice address
11400 W Olympic Blvd Ste 660
Los Angeles, CA 90064-1679
Phone
(310) 935-0032
Fax
(310) 935-0042
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Dr. Neevon Carl Esmaili, MDNPI 1801051248
Title
President
Phone
(310) 935-0032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X A115518 CA Primary

Addresses

Primary practice location

11400 W Olympic Blvd Ste 660
Los Angeles, CA 90064-1679

Mailing address

11400 W Olympic Blvd Ste 660
Los Angeles, CA 90064-1679
Phone (310) 935-0032

Other names 1

  • Mental Fitness Clinic Child, Adolescent & Adult Health Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1245609627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 W OLYMPIC BLVD STE 660",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641679",
            "telephone_number": "310-935-0032",
            "fax_number": "310-935-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 W OLYMPIC BLVD STE 660",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641679",
            "telephone_number": "310-935-0032",
            "fax_number": "310-935-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NEEVON C. ESMAILI, MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "ESMAILI",
        "authorized_official_first_name": "NEEVON",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-935-0032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A115518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Fitness Clinic Child, Adolescent & Adult Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mental Fitness Clinic Child, Adolescent & Adult Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.