Maryam Fathi Javanbakht, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT32607 Issued in CA

Practice address

544 S San Vicente Blvd
Los Angeles, CA 90048

Phone

(310) 355-8825

NPI assigned

Jun 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Maryam Fathi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1720438625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12542 CHARLOMA DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802807",
            "telephone_number": "310-355-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 S SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-355-8825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "544 S San Vicente Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900484622",
            "country_code": "US",
            "telephone_number": "310-355-8825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVANBAKHT",
        "first_name": "MARYAM",
        "middle_name": "FATHI",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT32607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYAM",
            "last_name": "FATHI",
            "prefix": "MS.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Golnar Javaherforoush, D.D.S.
• Atoosa Javaheri, PSY.D
• Afsoon Sarah Javaherian, PHARM. D.
• Mehran Javaherian, DDS
• Sarah Javaherifar, MD, MPH
• Nathan A Javari, D.P.M.
• David Javdan, D.D.S.
• Joseph Javdan, DO
• Parviz Javdan, M.D.
• Ron Javdan, M.D.

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.