Mohsen Tanbakoochi Moghaddam, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A46373 Issued in CA

Practice address

19100 Ventura Blvd Ste 16
Tarzana, CA 91356-3234

Phone

(818) 609-1314

Fax

(818) 609-0841

NPI assigned

Jul 7, 2006

Last updated

May 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243555200000",
    "number": "1720010234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19100 VENTURA BLVD STE 16",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563234",
            "telephone_number": "818-609-1314",
            "fax_number": "818-609-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19100 VENTURA BLVD STE 16",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563234",
            "telephone_number": "818-609-1314",
            "fax_number": "818-609-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "MOHSEN",
        "middle_name": "TANBAKOOCHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A46373",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A46373",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A46373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A463732",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Narine Mnatsakanyan
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• Michael Mocadam, PHARM D
• Modern DME LLC
• Mary Margaret Moebius, MD
• Mohammad Abuzaineh MD Inc a Professional Corporation
• Jasmine Molett, BEHAVIORAL THERAPIST
• Jennifer Molina
• Karen Molina, RADT
• Sevim Mollova, BCBA

• General Practice Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.