Reza Danesh, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A055334 Issued in CA

Practice address

10931 Cherry St
Suite 200
Los Alamitos, CA 90720-2496

Phone

(562) 497-9229

NPI assigned

Sep 15, 2006

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Jose Community Clinic

  • Clinic/Center
  • Hawthorne, CA
  • NPI 1285751024
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1649376229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10931 CHERRY ST",
            "address_2": "SUITE 200",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202496",
            "telephone_number": "562-497-9229",
            "fax_number": "562-431-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 CHERRY ST",
            "address_2": "SUITE 200",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202496",
            "telephone_number": "562-497-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANESH",
        "first_name": "REZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A055334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A55334",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Custom Compounding Centers LLC
• Cynthia W Chao D O a Professional Corporation
• Cynthia W Chao D O a Professional Corporation
• David Nima Dabiri
• Dahn Medical Inc
• Azar Daneshbod, MD
• Daniel D Wicorek DDS Inc
• Danny Phu, M.D.,Inc
• Jamie Darling
• Gerald Davelaar

• General Practice Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.