Ghazal Pooya

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21397 Issued in CA

Practice address

20969 Ventura Blvd Ste 24
Woodland Hills, CA 91364-6622

Phone

(310) 425-4810

NPI assigned

Oct 10, 2011

Last updated

Aug 25, 2014By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1629352588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 24",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646622",
            "telephone_number": "310-425-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20969 VENTURA BLVD STE 24",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646622",
            "telephone_number": "310-425-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOYA",
        "first_name": "GHAZAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA21397",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Pondivida
• Janisse Celeste Ponte
• Kameron Alexandra Poole, M.D.
• Naomi Jacqueline Gladys Poole I, BT
• Pacharinee Poolperm, RPH
• Damien Rozell Pope Jr.
• Patricia Luce Pope, PH.D.
• Hesssed Porras
• Joette T Porteous, OTR
• Steven Michael Porter

• Medical Physician Assistant in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.