Individual provider Active NPI

Michel J. Mazouz, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1679628036
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A44045 Issued in CA
Practice address
1125 S Beverly Dr Ste 730
Los Angeles, CA 90035-1180
Phone
(310) 201-0626
Fax
(310) 277-2852
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A44045 CA Primary

Addresses

Primary practice location

1125 S Beverly Dr Ste 730
Los Angeles, CA 90035-1180

Mailing address

PO Box 67218
Los Angeles, CA 90067-0218
Phone (310) 201-0626

Other identifiers 1

IdentifierTypeStateIssuer
00A440450MedicaidCA

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
I20070426000500 CA Practitioner - Internal MedicinePractitioner - Other (Physician) 8628174380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1125 S Beverly Dr
Suite 730
Los Angeles, CA 90035-1180
Phone (310) 201-0626

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A44045CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michel J. Mazouz, M.D., a Medical Corporation Internal Medicine CurrentSince Feb 11, 1999 Accepting new patients
Axminster Medical Group Internal Medicine PastSince Feb 1, 2007 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

280 S Beverly Dr
Ste 411
Beverly Hills, CA 90212

4727 Wilshire Blvd
Ste 100
Los Angeles, CA 90010
Phone (213) 938-2942

1125 S Beverly Dr
Ste 730
Los Angeles, CA 90035
Phone (310) 201-0626

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mmazouz103265@direct.cshs.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1679628036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67218",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900670218",
            "telephone_number": "310-201-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR STE 730",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351180",
            "telephone_number": "310-201-0626",
            "fax_number": "310-277-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZOUZ",
        "first_name": "MICHEL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A44045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A440450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.