Organization Active NPI

Sean Kossari, M.D. a. Prof . Corp

  • Obstetrics & Gynecology Physician
  • Mission Hills, CA
National Provider Identifier
1780964965
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A68579 Issued in CA
Legal business name
SEAN KOSSARI, M.D. A. PROF . CORP
Practice address
14901 Rinaldi St Ste 320
Mission Hills, CA 91345-1255
Phone
(818) 365-1616
Fax
(818) 365-1811
NPI assigned
Aug 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Authorized official

Name
Shahram Kossari, MD
Title
President/ Owner
Phone
(818) 365-1616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A68579 CA Primary

Addresses

Primary practice location

14901 Rinaldi St Ste 320
Mission Hills, CA 91345-1255

Mailing address

14901 Rinaldi St
Unit 320
Mission Hills, CA 91345-1204
Phone (818) 365-1616

Other identifiers 1

IdentifierTypeStateIssuer
15255572590MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Sean Kossari MD a Prof Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513728000000",
    "number": "1780964965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 RINALDI ST",
            "address_2": "UNIT 320",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451204",
            "telephone_number": "818-365-1616",
            "fax_number": "818-365-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 RINALDI ST STE 320",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451255",
            "telephone_number": "818-365-1616",
            "fax_number": "818-365-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN KOSSARI, M.D. A. PROF . CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-12-20",
        "status": "A",
        "authorized_official_last_name": "KOSSARI",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "818-365-1616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A68579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15255572590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.