Danyl L Fakhrutdinov, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA57371 Issued in CA

Practice address

11333 N Sepulveda Blvd
Mission Hills, CA 91345-1116

Phone

(818) 869-7200

NPI assigned

Oct 18, 2019

Sex

Male

Sole proprietor

No

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.

• American Current Care of California, a Medical Corporation

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1750573622
  Medicare reassignment
• American Current Care of California, a Medical Corporation

  • Urgent Care Clinic/Center
  • Ontario, CA
  • NPI 1811464084
  NPD
• American Current Care of California, a Medical Corporation

  • Urgent Care Clinic/Center
  • Madera, CA
  • NPI 1922297985
  NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  NPD (past)
• Stephan T. Honda, MD Inc

  • Health Service Clinic/Center
  • Hawthorne, CA
  • NPI 1962586883
  NPD (past)

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1699318014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 N SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451116",
            "telephone_number": "818-869-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRUTDINOV",
        "first_name": "DANYL",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gloria Evangelista, LMFT
• Excellent Palliative and Hospice Care, Inc.
• Exclusive Recovery Center Inc
• Facey Medical Group a Medical Corporation
• Mehdi Fakhrai, MD
• Ludmila Falikovich, OT/L
• Family Planning Associates Medical Group Inc
• Family Planning Associates Medical Group Inc
• Valerie K Fannin, L.C.S.W.
• Iman Faragalla

• Physician Assistant in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.