Individual provider Active NPI

Tanya Zadeh

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1871227603
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8405 Beverly Blvd
Los Angeles, CA 90048-3401
Phone
(323) 653-1990
NPI assigned
Jul 16, 2022
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8405 Beverly Blvd
Los Angeles, CA 90048-3401

Mailing address

1000 S Fremont Ave Unit 22
BLDG a-6, 4TH Floor
Alhambra, CA 91803-8847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6043 Hollywood Blvd
Los Angeles, CA 90028-5411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Los Angeles Free Clinic CurrentSince Jan 6, 2024 Accepting new patients

Locations

6043 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 653-1990

8405 Beverly Blvd
West Hollywood, CA 90048
Phone (323) 653-1990

Organizations & group practices 1

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": "1657929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1871227603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S FREMONT AVE UNIT 22",
            "address_2": "BLDG A-6, 4TH FLOOR",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918038847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483401",
            "telephone_number": "323-653-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADEH",
        "first_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-16",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.