Individual provider Active NPI

Mojan Gabbay, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1447277371
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A86936 Issued in CA
Practice address
12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032
Phone
(310) 822-5066
Fax
(310) 827-4420
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A86936 CA Primary

Addresses

Primary practice location

12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032

Mailing address

11711 Ohio Ave Apt 304
Los Angeles, CA 90025-2271
Phone (310) 663-6449

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mgabbay350298@oc.providencedirect.org
Direct Messaging Address mgabbay350298@oc.providencedirect.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000552 CA Practitioner - Obstetrics/Gynecology 6800991647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Saint Louis University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12555 W Jefferson Blvd
Suite 301
Los Angeles, CA 90066-7032
Phone (424) 443-5555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
86936CAMDPharmacist
A86936CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 14, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 14, 2016 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
West Hills Hospital Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

12555 W Jefferson Blvd
#301
Los Angeles, CA 90066
Phone (424) 443-5555

11600 Indian Hills Rd
Mission Hills, CA 91345
Phone (818) 781-7097

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2001 Santa Monica Blvd
Ste 970W
Santa Monica, CA 90404
Phone (310) 829-7272

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1447277371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 OHIO AVE APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252271",
            "telephone_number": "310-663-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "310-822-5066",
            "fax_number": "310-827-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABBAY",
        "first_name": "MOJAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A86936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgabbay350298@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12555 W Jefferson Blvd Ste 301",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900667032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgabbay350298@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2001 Santa Monica Blvd Ste 970W",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904042199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.