Individual provider Active NPI

Mina Mortezai, D.O.

  • Internal Medicine Physician
  • West Hills, CA
National Provider Identifier
1770547325
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7240 Issued in CA
Practice address
22110 Roscoe Blvd
West Hills, CA 91304-3875
Phone
(818) 888-8042
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 20A7240 CA Primary

Addresses

Primary practice location

22110 Roscoe Blvd
West Hills, CA 91304-3875

Mailing address

PO Box 4315
West Hills, CA 91308-4315
Phone (818) 585-1910

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
I20060106000558 CA Practitioner - Internal Medicine 8123041993 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A7240CAMDInternal Medicine Physician
7240CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Abm Medical Clinic, Inc. CurrentSince Sep 1, 2012 Accepting new patients
West Hills Hospital Past Accepting new patients

Locations

21133 Costanso St
Woodland Hills, CA 91364
Phone (818) 222-8042

22554 Ventura Blvd
Ste 201
Woodland Hills, CA 91364
Phone (818) 222-8042

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770547325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4315",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913084315",
            "telephone_number": "818-585-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22110 ROSCOE BLVD",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913043875",
            "telephone_number": "818-888-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTEZAI",
        "first_name": "MINA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

Verify at the official NPI Registry.