Mondana Hatzidakis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19799 Issued in CA

Practice address

7601 Imperial Hwy Ste Jpi 3120
Downey, CA 90242

Phone

(562) 385-7611

NPI assigned

Aug 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• Pediatric Surgical Subspecialists

  • Pediatric Critical Care Medicine Physician
  • Austin, TX
  • NPI 1184815227
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1689820037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 IMPERIAL HWY STE JPI 3120",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423456",
            "telephone_number": "562-385-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 IMPERIAL HWY STE JPI 3120",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "90242",
            "telephone_number": "562-385-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATZIDAKIS",
        "first_name": "MONDANA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Almada Harshaw, CNA
• Dorcia Ernestine Hart, PHARM.D.
• Ross Hartwell, DC
• Dominique Harvey
• Areio Hashemi
• Lisa Lighthall Haubert
• Jesse Lynn Haver
• Debra Hawk, CRNA
• Shavon Hawkins, PA-C
• Farnaz Shadpour Hayavi, DDS

• Physician Assistant in Downey, CA
• Providers in Downey, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.