Organization Active NPI

Farshad Nowzari, MD Inc

  • Urology Physician
  • Gardena, CA
National Provider Identifier
1700294386
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A75966 Issued in CA
Legal business name
FARSHAD NOWZARI, MD INC
Doing business as
SoCal Advanced Urology
Practice address
1141 W Redondo Beach Blvd
Suite #303
Gardena, CA 90247-3586
Phone
(310) 538-2930
Fax
(310) 538-2932
NPI assigned
Jul 28, 2014
Organization subpart
Yes
Parent organization
FARSHAD NOWZARI, MD INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Dr. Farshad Nowzari, M.D.NPI 1689741423
Title
Physician/ Managing Partner
Phone
(310) 538-2930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A75966 CA Primary

Addresses

Primary practice location

1141 W Redondo Beach Blvd
Suite #303
Gardena, CA 90247-3586

Mailing address

1141 W Redondo Beach Blvd
Suite #303
Gardena, CA 90247-3586
Phone (310) 538-2930

Other names 1

  • SoCal Advanced Urology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140825002037 CA Part B Supplier - Clinic/Group Practice 7012135502 Receives reassigned benefits from 1 practitioner
Practice locations: Gardena, CA; Torrance, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2078397Socal Advanced Urology1141 W Redondo Beach Blvd Ste 303, Gardena, CA 90247Provider-performed microscopyMay 26, 2028

National Provider Directory

National Provider Directory
Part of
Farshad Nowzari MD Inc

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1700294386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "SUITE #303",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-538-2930",
            "fax_number": "310-538-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "SUITE #303",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-538-2930",
            "fax_number": "310-538-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARSHAD NOWZARI, MD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FARSHAD NOWZARI, MD INC",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "NOWZARI",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "PHYSICIAN/ MANAGING PARTNER",
        "authorized_official_telephone_number": "310-538-2930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A75966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoCal Advanced Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.