Organization Active NPI

Keyvan Yousefi, MD, Inc.

  • Rheumatology Physician
  • Los Angeles, CA
National Provider Identifier
1679607683
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A066667 Issued in CA
Legal business name
KEYVAN YOUSEFI, MD, INC.
Practice address
8631 W 3Rd St # 915E
Los Angeles, CA 90048-5901
Phone
(310) 888-7737
Fax
(310) 888-7754
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Keyvan Yousefi, MDNPI 1679650386
Title
President
Phone
(310) 888-7737

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X A066667 CA Primary

Addresses

Primary practice location

8631 W 3Rd St # 915E
Los Angeles, CA 90048-5901

Mailing address

8631 W 3Rd St # 915E
Los Angeles, CA 90048-5901
Phone (310) 888-7737

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220001151 CA Part B Supplier - Clinic/Group Practice 4183519762 Receives reassigned benefits from 1 practitioner
Practice locations: Inglewood, CA; Los Angeles, CA; Culver City, CA

National Provider Directory

National Provider Directory

Locations

8631 W 3rd St
Ste 1020E
Los Angeles, CA 90048
Phone (310) 423-3063

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679607683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST # 915E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-888-7737",
            "fax_number": "310-888-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST # 915E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-888-7737",
            "fax_number": "310-888-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYVAN YOUSEFI, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUSEFI",
        "authorized_official_first_name": "KEYVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-888-7737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A066667",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.