Individual provider Active NPI

Hoda Mazloum, PA-C

  • Physician Assistant
  • Beverly Hills, CA
National Provider Identifier
1427533199
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55914 Issued in CA
Practice address
8920 Wilshire Blvd Ste 520
Beverly Hills, CA 90211-1949
Phone
(310) 432-2880
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55914 CA Primary

Addresses

Primary practice location

8920 Wilshire Blvd Ste 520
Beverly Hills, CA 90211-1949

Mailing address

20 28TH Ave Apt C
Venice, CA 90291-6330
Phone (313) 318-8880

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

LicenseStateTypeSpecialty
55914CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1427533199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 28TH AVE APT C",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902916330",
            "telephone_number": "313-318-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD STE 520",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111949",
            "telephone_number": "310-432-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZLOUM",
        "first_name": "HODA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.