Individual provider Active NPI

Shaya Justin Noorian, BS

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1477012508
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A177515 Issued in CA
Practice address
1000 Veteran Ave # A641
Los Angeles, CA 90024-2704
Phone
(310) 825-8173
Fax
(310) 794-8837
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A177515 CA Primary

Addresses

Primary practice location

1000 Veteran Ave # A641
Los Angeles, CA 90024-2704

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

121 S Palm Dr Apt 602
Beverly Hills, CA 90212-3549
Phone (424) 772-9052

Other practice location 2

757 Westwood Plz Ste 7236
Los Angeles, CA 90095-3549
Phone (310) 267-7849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177515CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: snoorian695458@direct.uclahealth.org

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1477012508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VETERAN AVE # A641",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242704",
            "telephone_number": "310-825-8173",
            "fax_number": "310-794-8837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 S Palm Dr Apt 602",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902123549",
            "country_code": "US",
            "telephone_number": "424-772-9052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "757 Westwood Plz Ste 7236",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953549",
            "country_code": "US",
            "telephone_number": "310-267-7849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOORIAN",
        "first_name": "SHAYA",
        "middle_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A177515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.