Kianna Modir-Fatemi

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25914 Issued in CA

Practice address

25825 S. Vermont Ave.
Harbor City, CA 90710

Phone

(310) 517-2944

NPI assigned

Jun 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kianna Modir Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285830471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 BATAAN RD.",
            "address_2": "#2",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 S. VERMONT AVE.",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "90710",
            "telephone_number": "310-517-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODIR-FATEMI",
        "first_name": "KIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIANNA",
            "last_name": "MODIR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Felicia L. Mitchell, MFTI
• Latrice Mitchell, PSW
• Yvonne Miura-Shibata, RCP, RRT
• Sean Faust Moat, D.O.
• Heidi Christina Mock, M.D.
• Hannan I Mohammed
• Katelyn Moir, RDN
• Cecilia M. Mola, MD
• Kathryn Ann Monroy, RD,CDE
• Lisa M. Montes, MD

• Physical Therapist in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.