Kameron Rezzadeh MD PC Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

KAMERON REZZADEH MD PC INC

Practice address

436 N Bedford Dr Ste 214
Beverly Hills, CA 90210-4312

Phone

(310) 275-6600

Fax

(310) 275-6607

NPI assigned

Dec 9, 2022

Organization subpart

No

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

Authorized official

Name

Kameron Rezzadeh, MDNPI 1871955153

Title

President

Phone

(310) 275-6600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kameron S Rezzadeh, MD

  • Plastic Surgery Physician
  • Beverly Hills, CA
  • NPI 1871955153
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1275244378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 MILLER DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691419",
            "telephone_number": "201-390-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 214",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104312",
            "telephone_number": "310-275-6600",
            "fax_number": "310-275-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMERON REZZADEH MD PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "REZZADEH",
        "authorized_official_first_name": "KAMERON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-275-6600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.