Individual provider Active NPI

Daniel Enayati, M.D.

  • General Practice Physician
  • South Gate, CA
National Provider Identifier
1861525016
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A55940 Issued in CA
Practice address
3175 E. Firestone Blvd
South Gate, CA 90280-2951
Phone
(323) 567-8910
Fax
(323) 567-8953
NPI assigned
Mar 14, 2007
Last updated
Jan 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A55940 CA Primary

Addresses

Primary practice location

3175 E. Firestone Blvd
South Gate, CA 90280-2951

Mailing address

3175 E. Firestone Blvd
South Gate, CA 90280-2951
Phone (323) 567-8910

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
I20051205000434 CA Practitioner - General Practice 4880614973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jose Torreblanca MD IncGroup PAC ID 2062638323, 3 clinicians

Practice addresses (Care Compare)

7128 Seville Ave
Huntington Park, CA 90255-4906
Phone (323) 588-2186

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55940CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jose Torreblanca MD Inc. General Practice CurrentSince Jun 1, 2018 Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients

Locations

7128 Seville Ave
Huntington Pk, CA 90255
Phone (213) 588-2186

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1861525016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 E. FIRESTONE BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802951",
            "telephone_number": "323-567-8910",
            "fax_number": "323-567-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 E. FIRESTONE BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802951",
            "telephone_number": "323-567-8910",
            "fax_number": "323-567-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENAYATI",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A55940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.