Active NPI
Bahman Moghaddas
- Optician
- Van Nuys, CA
National Provider Identifier
1689852022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SL5568
- Practice address
- 6800 Balboa Blvd Ste G
Van Nuys, CA 91406-4578 - Phone
- (818) 902-1919
- Fax
- (818) 902-0505
- NPI assigned
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | SL5568 | CA | Primary |
Addresses
Primary practice location
6800 Balboa Blvd Ste G
Van Nuys, CA 91406-4578
Mailing address
6800 Balboa Blvd Ste G
Van Nuys, CA 91406-4578
Phone (818) 902-1919
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL5568 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1689852022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 BALBOA BLVD STE G",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914064578",
"telephone_number": "818-902-1919",
"fax_number": "818-902-0505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 BALBOA BLVD STE G",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914064578",
"telephone_number": "818-902-1919",
"fax_number": "818-902-0505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADDAS",
"first_name": "BAHMAN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "SL5568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.