Individual provider Active NPI

Babak Pezeshki, MD, MPH

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1710376926
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A150504 Issued in CA
Practice address
2011 Wilshire Blvd
Los Angeles, CA 90057-3503
Phone
(213) 413-2700
NPI assigned
Jan 12, 2015
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A150504 CA Primary

Addresses

Primary practice location

2011 Wilshire Blvd
Los Angeles, CA 90057-3503

Mailing address

2007 Wilshire Blvd
Ste 300
Los Angeles, CA 90057-3506
Phone (213) 413-2700

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227000832 CA Practitioner - Internal Medicine 7416295258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2011 Wilshire Blvd
Suite 826
Los Angeles, CA 90057-3503
Phone (213) 413-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Pezeshki MD Inc CurrentSince Oct 31, 2018 Accepting new patients

Locations

2007 Wilshire Blvd
Ste 300
Los Angeles, CA 90057

2011 Wilshire Blvd
Ste 300
Los Angeles, CA 90057
Phone (213) 205-1890

2011 Wilshire Blvd
Ste 826
Los Angeles, CA 90057
Phone (213) 413-2700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1710376926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 WILSHIRE BLVD",
            "address_2": "STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573506",
            "telephone_number": "213-413-2700",
            "fax_number": "213-413-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573503",
            "telephone_number": "213-413-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A150504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.