Individual provider Active NPI

Anthony Charles Bejjani, MD

  • Hematology & Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1295153740
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A143151 Issued in CA
Practice address
200 Medical Plaza Suite 120
Los Angeles, CA 90095-2673
Phone
(310) 825-6301
Fax
(310) 794-1699
NPI assigned
Apr 2, 2014
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A143151 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

200 Medical Plaza Suite 120
Los Angeles, CA 90095-2673

Mailing address

22525 N Summit Ridge Cir
Chatsworth, CA 91311-2673
Phone (818) 522-5949

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
I20181113000536 CA Order and Referring Only - Hematology/OncologyPractitioner - Hematology/Oncology 8325392228

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143151CAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1295153740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22525 N SUMMIT RIDGE CIR",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112673",
            "telephone_number": "818-522-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA SUITE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952673",
            "telephone_number": "310-825-6301",
            "fax_number": "310-794-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJJANI",
        "first_name": "ANTHONY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A143151",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.