NPIMap

Organization Active NPI

Southern California Neurology Medical Group, Inc.

  • Neurology Physician
  • Pasadena, CA
National Provider Identifier
1639461825
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SOUTHERN CALIFORNIA NEUROLOGY MEDICAL GROUP, INC.
Practice address
625 S Fair Oaks Ave
Suite 325
Pasadena, CA 91105-2613
Phone
(626) 535-9344
Fax
(626) 535-9387
NPI assigned
May 6, 2011
Last updated
Oct 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Authorized official

Name
Dr. Yafa Minazad, D.O.NPI 1982636122
Title
Owner
Phone
(626) 535-9344

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
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

625 S Fair Oaks Ave
Suite 325
Pasadena, CA 91105-2613

Mailing address

625 S Fair Oaks Ave
Suite 325
Pasadena, CA 91105-2613
Phone (626) 535-9344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120427000492 CA Part B Supplier - Clinic/Group Practice 5294997854 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Pasadena, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
05D2297938Southern California Neurology Medical Group625 S Fair Oaks Ave Ste 325, Pasadena, CA 91105Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 12

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": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761350400000",
    "number": "1639461825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE",
            "address_2": "SUITE 325",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-535-9344",
            "fax_number": "626-535-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE",
            "address_2": "SUITE 325",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052613",
            "telephone_number": "626-535-9344",
            "fax_number": "626-535-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA NEUROLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A",
        "authorized_official_last_name": "MINAZAD",
        "authorized_official_first_name": "YAFA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-535-9344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2025; 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.