Ibrahim Raef Hajjali, MD, MSC

Primary specialty

Clinical Pathology PhysicianTaxonomy code 207ZC0006X

License

A186520 Issued in CA

Practice address

1441 Eastlake Ave Ste 2424K
Los Angeles, CA 90089-1020

Phone

(626) 689-1931

NPI assigned

Jul 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Pathology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
• Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306

  Anatomic Pathology & Clinical Pathology

  Medicare reassignment Care Compare group NPD
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Usc University Hospital, Inc.

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1790718500
  NPD (past)
• Usc Verdugo Hills Hospital, LLC

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1265875207
  NPD (past)

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

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• Keck Medical Center of Usc

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1013514199
  Care Compare affiliation
• Keck Medical Center of Usc

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1417554528
  Care Compare affiliation

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697241600000",
    "number": "1891347738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE STE 2424K",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891020",
            "telephone_number": "626-689-1931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 N Nevada Ave",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809076819",
            "country_code": "US",
            "telephone_number": "719-776-5816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAJJALI",
        "first_name": "IBRAHIM",
        "middle_name": "RAEF",
        "credential": "MD, MSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2023-10-14",
        "certification_date": "2023-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL.0006862",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "CA",
            "license": "A186520",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A186520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babak Hajhosseini, M.D.
• Farnaz Haji, M.D, D.O
• Hagop Hajian, M.D.
• Susan Carla Hajiani, MSW
• Iqra Hajidamji
• Danielle Nicole Hajjar, MS CCC-SLP
• Hamid Reza Hajmomenian, MD
• Hajo Holistic Acupuncture
• Hak Cheon Kim DDS Inc
• Hak S. Choi DDS Inc

• Clinical Pathology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.