Organization Active NPI

Mojgan Makhsoosi, M.D. Inc.

  • Internal Medicine Physician
  • Simi Valley, CA
National Provider Identifier
1841354073
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A70736 Issued in CA
Legal business name
MOJGAN MAKHSOOSI, M.D. INC.
Practice address
2750 Sycamore Dr
Suite 209
Simi Valley, CA 93065-1502
Phone
(805) 915-0315
Fax
(805) 915-0317
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Authorized official

Name
Dr. Mojgan MakhsoosiNPI 1346218658
Title
President
Phone
(805) 915-0315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A70736 CA Primary

Addresses

Primary practice location

2750 Sycamore Dr
Suite 209
Simi Valley, CA 93065-1502

Mailing address

PO Box 6604
Thousand Oaks, CA 91359-6604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070104000366 CA Part B Supplier - Clinic/Group Practice 9638179229 Receives reassigned benefits from 1 practitioner
Practice locations: Simi Valley, CA

National Provider Directory

National Provider Directory

Locations

111 E Arrow Hwy
Ste A
San Dimas, CA 91773

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1841354073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6604",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913596604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SYCAMORE DR",
            "address_2": "SUITE 209",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651502",
            "telephone_number": "805-915-0315",
            "fax_number": "805-915-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOJGAN MAKHSOOSI, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "MAKHSOOSI",
        "authorized_official_first_name": "MOJGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-915-0315",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.