Organization Active NPI

Aida K Rechdouni, MD Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • La Crescenta, CA
National Provider Identifier
1629458765
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A72786 Issued in CA
Legal business name
AIDA K RECHDOUNI, MD INC
Practice address
2626 Foothill Blvd Ste 102
La Crescenta, CA 91214-3574
Phone
(888) 610-8909
Fax
(888) 610-8908
NPI assigned
Jun 4, 2015
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Dr. Aida Karoun Rechdouni, M.D.NPI 1699814533
Title
President
Phone
(818) 468-2929

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF00342461 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A72786 CA Primary

Addresses

Primary practice location

2626 Foothill Blvd Ste 102
La Crescenta, CA 91214-3574

Mailing address

2750 Pineridge PL
La Crescenta, CA 91214-1458
Phone (818) 468-2929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150827000903 CA Part B Supplier - Clinic/Group Practice 5092021691 Receives reassigned benefits from 1 practitioner
Practice locations: La Crescenta, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2047227Aida K. Rechdouni MD Inc2626 Foothill Blvd, Ste 102, La Crescenta, CA 91214ComplianceMay 30, 2027

National Provider Directory

National Provider Directory

Locations

2626 Foothill Blvd
La Crescenta, CA 91214

2626 Foothill Blvd
Ste 102
La Crescenta, CA 91214
Phone (888) 468-2929

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1629458765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 PINERIDGE PL",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141458",
            "telephone_number": "818-468-2929",
            "fax_number": "888-610-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 FOOTHILL BLVD STE 102",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143574",
            "telephone_number": "888-610-8909",
            "fax_number": "888-610-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIDA K RECHDOUNI, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "RECHDOUNI",
        "authorized_official_first_name": "AIDA",
        "authorized_official_middle_name": "KAROUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-468-2929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF00342461",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A72786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.