Individual provider Active NPI

Pouya Bahrami, DO

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871526301
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7262 Issued in CA
Practice address
1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067
Phone
(213) 481-2200
Fax
(213) 481-7023
NPI assigned
Jul 8, 2006
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A7262 CA Primary

Addresses

Primary practice location

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3067

Mailing address

1414 S Grand Ave
Ste 100
Los Angeles, CA 90015-3067
Phone (213) 481-2200

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
I20040228000568 CA Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 0749177368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
University of New England, College of Osteo Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1414 S Grand Ave
Suite 100
Los Angeles, CA 90015-3071
Phone (213) 481-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7262CAMDOptometrist
20A7262CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Medical Clinic Internal Medicine Current Accepting new patients
Pouya Bahrami DO Inc. Current Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients

Locations

12610 S Western Ave
Los Angeles, CA 90047
Phone (323) 757-1853

1414 S Grand Ave
Ste 100
Los Angeles, CA 90015
Phone (213) 481-2200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1871526301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-481-2200",
            "fax_number": "213-481-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153067",
            "telephone_number": "213-481-2200",
            "fax_number": "213-481-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHRAMI",
        "first_name": "POUYA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.