Ilan Bazak DPM Professional Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0559350001 Issued in CA

Legal business name

ILAN BAZAK DPM PROFESSIONAL CORP

Practice address

1121 N Fairfax Ave
West Hollywood, CA 90046-5306

Phone

(323) 650-6363

Fax

(323) 650-4377

NPI assigned

Jun 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ilan Bazak, D.P.MNPI 1932153970

Title

Owner

Phone

(323) 650-6363

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Ilan Bazak, DPM

  • Podiatrist
  • Los Angeles, CA
  • NPI 1932153970
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1396906111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 N FAIRFAX AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465306",
            "telephone_number": "323-650-6363",
            "fax_number": "323-650-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N FAIRFAX AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465306",
            "telephone_number": "323-650-6363",
            "fax_number": "323-650-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILAN BAZAK DPM PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BAZAK",
        "authorized_official_first_name": "ILAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-650-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "0559350001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry S Hymes, MFC
• Hyung S Kim MD a Professional
• Karim Ali Ibrahim, MD
• Jecelle Iglesias, RN
• Sharon Ignarro, MD
• Hilda Ilanjian, PHARM.D.
• Diana Ilinsky, PHARMD
• Kenneth David Illingworth, M.D.
• Jonathan Kalengayi Ilunga
• Yoonsun Im

• Durable Medical Equipment & Medical Supplies in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.