Active NPI
Iradj Ghadishah, M.D.
- General Practice Physician
- Culver City, CA
National Provider Identifier
1376564401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A50282
- Practice address
- 9808 Venice Blvd
Suite 710
Culver City, CA 90232-2732 - Phone
- (310) 470-8220
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A50282 | CA | Primary |
Addresses
Primary practice location
9808 Venice Blvd
Suite 710
Culver City, CA 90232-2732
Mailing address
10660 Wilshire Blvd
Suite 1108
Los Angeles, CA 90024-4522
Phone (310) 470-8220
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040322001691 | CA | Practitioner - General Practice | 3678464401 | Practice locations: Los Angeles, CA |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 1961
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10660 Wilshire Blvd
Apt 1108
Los Angeles, CA 90024-4526
Phone (310) 470-8220
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A50282 | CA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horacio F Ariza MD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Culver City, CA
- NPI 1760685515
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Skilled Nursing Facility
- Inglewood, CA
- NPI 1891940276
Nursing home
-
- Skilled Nursing Facility
- Inglewood, CA
- NPI 1265687644
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376564401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10660 WILSHIRE BLVD",
"address_2": "SUITE 1108",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900244522",
"telephone_number": "310-470-8220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9808 VENICE BLVD",
"address_2": "SUITE 710",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902322732",
"telephone_number": "310-470-8220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHADISHAH",
"first_name": "IRADJ",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A50282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.