Healthy Heart Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALTHY HEART MEDICAL GROUP INC

Practice address

12502 Van Nuys Blvd
104
Pacoima, CA 91331

Phone

(818) 899-5555

Fax

(818) 899-5969

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Daryoush Yallya Kashani, MD

Title

President

Phone

(818) 899-5555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacoima Primary Care Medical Clinic Doing business as

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467511592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18653 VENTURA BLVD",
            "address_2": "289",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-899-5555",
            "fax_number": "818-899-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 VAN NUYS BLVD",
            "address_2": "104",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "91331",
            "telephone_number": "818-899-5555",
            "fax_number": "818-899-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY HEART MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASHANI",
        "authorized_official_first_name": "DARYOUSH",
        "authorized_official_middle_name": "YALLYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-899-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A666980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacoima Primary Care Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hathaway-Sycamores Child and Family Services
• Hathaway-Sycamores Child and Family Services
• Hathaway-Sycamores Child and Family Services
• Hathaway-Sycamores Child and Family Services
• Hathaway-Sycamores Child and Family Services
• Jessica Lee Held, LCSW
• Gabriela Hernandez
• Jazmine Hernandez, SLPA
• Lorenzo Hernandez
• Reina Hernandez

• Family Medicine Physician in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.