Crystal Imankhan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT35507-TLG Issued in CA

Practice address

1230 Horn Ave
West Hollywood, CA 90069-2121

Phone

(360) 951-1457

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

OptometryAlso: Ophthalmology

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A. Ebbie Soroudi, MD, Ms a Professional Medical Corporation

  • Ophthalmology Physician
  • Beverly Hills, CA
  • NPI 1225047509
  Medicare reassignment NPD

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1467130765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11384",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 HORN AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900692121",
            "telephone_number": "360-951-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMANKHAN",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35507-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Ilinsky, PHARMD
• Kenneth David Illingworth, M.D.
• Jonathan Kalengayi Ilunga
• Yoonsun Im
• Kim Eing Imada, PHARMD
• Ryan Michael Ingram, PSYD
• Eno Elizabeth Inikori, MD
• Patil Injean, DO
• Innova RX Inc.
• Insight Choices Community Wellness PC

• Optometrist in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.