Organization Active NPI

B Moussazadeh a Medical Corporation

  • Pain Medicine (Anesthesiology) Physician
  • Tarzana, CA
National Provider Identifier
1376043513
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A108651 Issued in CA
Legal business name
B MOUSSAZADEH A MEDICAL CORPORATION
Practice address
5620 Wilbur Ave Ste 305
Tarzana, CA 91356-1311
Phone
(818) 588-4741
Fax
(818) 588-4748
NPI assigned
Feb 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Mrs. Cheyenne Kaipat
Title
Office Manager
Phone
(818) 588-4741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X A108651 CA Primary

Addresses

Primary practice location

5620 Wilbur Ave Ste 305
Tarzana, CA 91356-1311

Mailing address

5620 Wilbur Ave Ste 305
Tarzana, CA 91356-1311
Phone (818) 588-4741

Other practice location 1

5620 Wilbur Ave Ste 301
Tarzana, CA 91356-1351
Phone (818) 588-4741 ext. 101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cheyenne@californiapaindocs.com

National Provider Directory

National Provider Directory

Locations

5620 Wilbur Ave
Ste 301
Tarzana, CA 91356
Phone 8185884741 ext. 101

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1376043513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE STE 305",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561311",
            "telephone_number": "818-588-4741",
            "fax_number": "818-588-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE STE 305",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561311",
            "telephone_number": "818-588-4741",
            "fax_number": "818-588-4748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5620 Wilbur Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913561351",
            "country_code": "US",
            "telephone_number": "818-588-4741 x101",
            "fax_number": "818-588-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "B MOUSSAZADEH A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "KAIPAT",
        "authorized_official_first_name": "CHEYENNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-588-4741",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A108651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cheyenne@californiapaindocs.com",
            "affiliation": "N",
            "address_1": "5620 Wilbur Ave Ste 305",
            "city": "Tarzana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913561311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.