Individual provider Active NPI

Moosa Kohanim, M.D.

  • Specialist
  • Lawndale, CA
National Provider Identifier
1477581239
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A35085 Issued in CA
Practice address
14516 Hawthorne Blvd
Lawndale, CA 90260-1519
Phone
(310) 219-0890
Fax
(310) 219-0297
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A35085 CA Primary

Addresses

Primary practice location

14516 Hawthorne Blvd
Lawndale, CA 90260-1519

Mailing address

14516 Hawthorne Blvd
Lawndale, CA 90260-1519
Phone (310) 219-0890

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1477581239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14516 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601519",
            "telephone_number": "310-219-0890",
            "fax_number": "310-219-0297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14516 HAWTHORNE BLVD",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902601519",
            "telephone_number": "310-219-0890",
            "fax_number": "310-219-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHANIM",
        "first_name": "MOOSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A35085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawndale, CA

Sources for this page

Verify at the official NPI Registry.