Reza Bonabi MD, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A46355 Issued in CA

Legal business name

REZA BONABI MD, INC

Practice address

17075 Devonshire St
Suite 301
Northridge, CA 91325-1600

Phone

(818) 368-4212

Fax

(818) 366-9351

NPI assigned

Jul 23, 2008

Last updated

Jul 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nagadeh Gholamreza Bonabi, M.D.

Title

Physician

Phone

(818) 368-4212

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Gholamreza Nagadeh Bonabi, M.D.,

  • Specialist
  • Northridge, CA
  • NPI 1154439743
  NPD (past)
• Joseph Kerendian, MD

  • Ophthalmology Physician
  • Northridge, CA
  • NPI 1386643815
  NPD (past)

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1366607988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 301",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-368-4212",
            "fax_number": "818-366-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 301",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-368-4212",
            "fax_number": "818-366-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA BONABI MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "BONABI",
        "authorized_official_first_name": "NAGADEH",
        "authorized_official_middle_name": "GHOLAMREZA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "818-368-4212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A46355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A463550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Araceli Reyes
• Nicole Renee Reyes
• Odette Reyes
• Victoria Reyes
• Charles Andrew Reynolds, PHARM.D., B.C.P.P.
• Hamid Reza
• Martha Ruth Reza, PH. D.
• Sahar Rezvani, D.D.S
• Doris Rezvanpour, PHARM D
• Hanna X Rhee, ACUPUNCTURE LAC

• Specialist in Northridge, CA
• Providers in Northridge, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.