Individual provider Active NPI

Mahnoush Babaei, M.D

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1669642062
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A102843 Issued in CA
Practice address
2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone
(213) 699-7075
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X A102843 CA
Internal Medicine Physician 207R00000X A102843 CA Primary

Addresses

Primary practice location

2829 S Grand Ave
Los Angeles, CA 90007-3304

Mailing address

2189 N Altadena Dr
Altadena, CA 91001-3533
Phone (626) 398-8232

Other identifiers 1

IdentifierTypeStateIssuer
A102843OtherCAINTERNIST

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110630000510 CA Practitioner - Internal Medicine 4981882594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

2829 S Grand Ave
Los Angeles, CA 90007-3304
Phone (213) 699-7013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A102843CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Oct 5, 2016 Accepting new patients
County of Los Angeles CurrentSince Oct 5, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

2829 S Grand Ave
Los Angeles, CA 90007
Phone (213) 699-7000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1669642062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 N ALTADENA DR",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013533",
            "telephone_number": "626-398-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073304",
            "telephone_number": "213-699-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABAEI",
        "first_name": "MAHNOUSH",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A102843",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNIST",
            "identifier": "A102843",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.