Organization Active NPI

Hooman Madyoon MD Inc

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1508645540
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HOOMAN MADYOON MD INC
Practice address
640 S San Vicente Blvd Ste 350
Los Angeles, CA 90048-4659
Phone
(310) 492-8858
Fax
(310) 708-0175
NPI assigned
Sep 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Hooman Madyoon, MDNPI 1285696476
Title
Owner
Phone
(310) 289-9955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

640 S San Vicente Blvd Ste 350
Los Angeles, CA 90048-4659

Mailing address

640 S San Vicente Blvd Ste 350
Los Angeles, CA 90048-4659
Phone (310) 289-9955

Other practice location 1

99 N La Cienega Blvd Ste 203
Beverly Hills, CA 90211-2285
Phone (310) 289-9955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240122003616 CA Part B Supplier - Clinic/Group Practice 9830541242 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

50 N La Cienega Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 659-0989

640 S San Vicente Blvd
Ste 640
Los Angeles, CA 90048

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1508645540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S SAN VICENTE BLVD STE 350",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484659",
            "telephone_number": "310-289-9955",
            "fax_number": "310-289-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S SAN VICENTE BLVD STE 350",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484659",
            "telephone_number": "310-492-8858",
            "fax_number": "310-708-0175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 N La Cienega Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902112285",
            "country_code": "US",
            "telephone_number": "310-289-9955",
            "fax_number": "310-289-9959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOOMAN MADYOON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "MADYOON",
        "authorized_official_first_name": "HOOMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-289-9955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.