Active NPI
Ilbron Tamrazzadeh, MASSAGE THERAPY
- Massage Therapist
- Glendale, CA
National Provider Identifier
1427443050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33223
- Practice address
- 1016 E Broadway
Suite #101
Glendale, CA 91205-4532 - Phone
- (818) 396-9080
- Fax
- (818) 296-9388
- NPI assigned
- Mar 31, 2015
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 33223 | CA | Primary |
Addresses
Primary practice location
1016 E Broadway
Suite #101
Glendale, CA 91205-4532
Mailing address
1016 E Broadway
Suite #101
Glendale, CA 91205-4532
Phone (818) 396-9080
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33223 | CA | MD | Mental Health Counselor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1427443050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 E BROADWAY",
"address_2": "SUITE #101",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912054532",
"telephone_number": "818-396-9080",
"fax_number": "818-296-9388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 E BROADWAY",
"address_2": "SUITE #101",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912054532",
"telephone_number": "818-396-9080",
"fax_number": "818-296-9388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMRAZZADEH",
"first_name": "ILBRON",
"credential": "MASSAGE THERAPY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-31",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "33223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.