Active NPI
Afshin Azizisefat
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1659746345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 74195
- Practice address
- 10407 Santa Monica Blvd
Los Angeles, CA 90025-5009 - Phone
- (818) 708-0258
- NPI assigned
- Dec 6, 2015
- Last updated
- Jun 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 74195 | CA | Primary |
Addresses
Primary practice location
10407 Santa Monica Blvd
Los Angeles, CA 90025-5009
Mailing address
6144 Dewey Dr
Citrus Heights, CA 95621-6212
Phone (916) 723-4118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 74195 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465689600000",
"number": "1659746345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6144 DEWEY DR",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956216212",
"telephone_number": "916-723-4118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10407 SANTA MONICA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900255009",
"telephone_number": "818-708-0258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZIZISEFAT",
"first_name": "AFSHIN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-06",
"last_updated": "2016-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 74195",
"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 Jun 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.