Homeira Izadi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A86985 Issued in CA

Practice address

325 Sharon Park Drive
D4
Menlo Park, CA 94025

Phone

(650) 487-0844

Fax

(650) 924-9888

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Valley Children'S Specialty Medical Group, Inc.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1013968296
  NPD (past)
• Baylor College of Medicine

  • Family Medicine Physician
  • Houston, TX
  • NPI 1316016694
  NPD (past)
• Baylor College of Medicine

  • Children's Hospital
  • Houston, TX
  • NPI 1619211034
  NPD (past)
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1790865038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4061 E CASTRO VALLEY BLVD # 13",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945524840",
            "telephone_number": "650-487-0844",
            "fax_number": "650-924-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SHARON PARK DRIVE",
            "address_2": "D4",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-487-0844",
            "fax_number": "650-924-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6621 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302303",
            "country_code": "US",
            "telephone_number": "832-826-1380",
            "fax_number": "832-825-2799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "570 Price Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940631433",
            "country_code": "US",
            "telephone_number": "650-701-1882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IZADI",
        "first_name": "HOMEIRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A86985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173191101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Koji Ichihashi, L.AC.
• Inadvance Medicine Associates West, P. C.
• Therese Inkmann, MA, LMFT
• Megan Irvin, LMFT
• Vince Iwuji, RN
• Robert Lionel Jack, M.D.
• Alison Moon Jackson, PSY.D.
• Jacqueline D.S. Jackson, PH.D.
• Lisa Jacobs, M.D.
• Matthew Townsend Jacobs

• Pediatrics Physician in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.