Organization Active NPI

Masoud M Azizad MD Inc

  • Internal Medicine Physician
  • Northridge, CA
National Provider Identifier
1376501080
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A74207 Issued in CA
Legal business name
MASOUD M AZIZAD MD INC
Practice address
18433 Roscoe Blvd
#208
Northridge, CA 91325-4108
Phone
(818) 341-4401
Fax
(818) 341-4402
NPI assigned
May 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Authorized official

Name
Mr. Masoud M Azizad, MDNPI 1033174826
Title
Ceo
Phone
(818) 341-4401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A74207 CA Primary

Addresses

Primary practice location

18433 Roscoe Blvd
#208
Northridge, CA 91325-4108

Mailing address

18433 Roscoe Blvd
208
Northridge, CA 91325-4108
Phone (818) 341-4401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060307000870 CA Part B Supplier - Clinic/Group Practice 6406863075 Receives reassigned benefits from 1 practitioner
Practice locations: Northridge, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1001519Masoud M Azizad MD18433 Roscoe Blvd Suite 208, Northridge, CA 91325Certificate of waiverJul 11, 2028

National Provider Directory

National Provider Directory

Locations

18433 Roscoe Blvd
Ste 208
Northridge, CA 91325
Phone (818) 341-4401

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1376501080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "208",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-341-4401",
            "fax_number": "818-341-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 ROSCOE BLVD",
            "address_2": "#208",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254108",
            "telephone_number": "818-341-4401",
            "fax_number": "818-341-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASOUD M AZIZAD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "AZIZAD",
        "authorized_official_first_name": "MASOUD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-341-4401",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A74207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.