Organization Active NPI

Kenneth Nazari MD a Medical Corporation

  • Psychiatry Physician
  • Inglewood, CA
National Provider Identifier
1306034434
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KENNETH NAZARI MD A MEDICAL CORPORATION
Practice address
501 E Hardy St
#424
Inglewood, CA 90301-4054
Phone
(775) 751-0777
Fax
(775) 751-8777
NPI assigned
Oct 15, 2007
Last updated
Jan 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Dr. Kennth Nazari, M.D.
Title
M.D.
Phone
(775) 751-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

501 E Hardy St
#424
Inglewood, CA 90301-4054

Mailing address

501 E Hardy St Ste 160
Inglewood, CA 90301-4033
Phone (775) 751-0777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090203000441 CA Part B Supplier - Clinic/Group Practice 1153216536 Receives reassigned benefits from 1 practitioner
Practice locations: Inglewood, CA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

501 E Hardy St
Ste 424
Inglewood, CA 90301
Phone (310) 671-9980

Practitioners & affiliated clinicians

Practitioners 1

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": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1306034434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST STE 160",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014033",
            "telephone_number": "775-751-0777",
            "fax_number": "775-751-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HARDY ST",
            "address_2": "#424",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014054",
            "telephone_number": "775-751-0777",
            "fax_number": "775-751-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH NAZARI MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "NAZARI",
        "authorized_official_first_name": "KENNTH",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "775-751-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.