Active NPI
Mukti Palejwala, P.A.
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1679688402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 17666
- Practice address
- 3545 Wilshire Blvd
Suite 315
Los Angeles, CA 90010-2354 - Phone
- (213) 385-0630
- Fax
- (213) 385-0675
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 17666 | CA | Primary |
Addresses
Primary practice location
3545 Wilshire Blvd
Suite 315
Los Angeles, CA 90010-2354
Mailing address
3545 Wilshire Blvd
Suite 315
Los Angeles, CA 90010-2354
Phone (213) 385-0630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA 17666 | Other | CA | P.A. LICENCE |
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 17666 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sergey Belikov, M.D., Prof. Corp. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- West Hills, CA
- NPI 1396926200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679688402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3545 WILSHIRE BLVD",
"address_2": "SUITE 315",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102354",
"telephone_number": "213-385-0630",
"fax_number": "213-385-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3545 WILSHIRE BLVD",
"address_2": "SUITE 315",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900102354",
"telephone_number": "213-385-0630",
"fax_number": "213-385-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALEJWALA",
"first_name": "MUKTI",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 17666",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P.A. LICENCE",
"identifier": "PA 17666",
"state": "CA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.