Individual provider Active NPI

Koby Moridzadeh, RD

  • Registered Dietitian
  • Anaheim, CA
National Provider Identifier
1396935607
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
876998 Issued in CA
Practice address
7150 E Colter Cir
Anaheim, CA 92807-4510
Phone
(714) 281-1235
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 876998 CA Primary

Addresses

Primary practice location

7150 E Colter Cir
Anaheim, CA 92807-4510

Mailing address

7150 E Colter Cir
Anaheim, CA 92807-4510
Phone (714) 281-1235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1396935607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 E COLTER CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074510",
            "telephone_number": "714-281-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 E COLTER CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074510",
            "telephone_number": "714-281-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIDZADEH",
        "first_name": "KOBY",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "876998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; 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.