Individual provider Active NPI

Afsoon Adl Gostar

  • Medical Physician Assistant
  • Van Nuys, CA
National Provider Identifier
1699487082
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
14550 Haynes St Ste 204
Van Nuys, CA 91411-4112
Phone
(818) 672-9863
NPI assigned
Dec 19, 2022
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

14550 Haynes St Ste 204
Van Nuys, CA 91411-4112

Mailing address

6606 Variel Ave Apt 501
Canoga Park, CA 91303-3867
Phone (424) 537-6769

Other practice location 1

20011 Ventura Blvd Ste 1002
Woodland Hills, CA 91364-2573
Phone (818) 528-5525

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250728000596 CA Practitioner - Physician Assistant 2961919741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
66617CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Medical Center, Inc. CurrentSince Jul 29, 2025 Accepting new patients
Southern California Medical Center, Inc. Past Accepting new patients

Locations

12100 Valley Blvd
Ste 109A
El Monte, CA 91732
Phone (626) 575-7500

14550 Haynes St
Ste 204
Van Nuys, CA 91411
Phone (818) 650-6700

20011 Ventura Blvd
#1002
Woodland Hills, CA 91364
Phone (818) 708-6163

20011 Ventura Blvd
Ste 1002
Woodland Hills, CA 91364
Phone (818) 708-6163

Interoperability endpoints

  • Direct secure messaging: afsoonpa.adlgostar.p1@direct.scmedcenter.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1699487082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6606 VARIEL AVE APT 501",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033867",
            "telephone_number": "424-537-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 HAYNES ST STE 204",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914114112",
            "telephone_number": "818-672-9863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20011 Ventura Blvd Ste 1002",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913642573",
            "country_code": "US",
            "telephone_number": "818-528-5525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADL GOSTAR",
        "first_name": "AFSOON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.