Organization Active NPI

Ohara Aivaz MD a Professional Corporation

  • Dermatology Physician
  • Beverly Hills, CA
National Provider Identifier
1902676695
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
OHARA AIVAZ MD A PROFESSIONAL CORPORATION
Practice address
400 S Beverly Dr Ste 380
Beverly Hills, CA 90212-4424
Phone
(415) 802-1310
NPI assigned
Jan 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Dr. Ohara Aivaz, MDNPI 1487946661
Title
Ceo
Phone
(415) 802-1310

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

400 S Beverly Dr Ste 380
Beverly Hills, CA 90212-4424

Mailing address

802 S Spaulding Ave
Los Angeles, CA 90036-4608
Phone (415) 802-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240301003248 CA Part B Supplier - Clinic/Group Practice 8820433659 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2301150Ohara Aivaz MD400 S Beverly Drive Suite 380, Beverly Hills, CA 90212Certificate of waiverMar 20, 2028

National Provider Directory

National Provider Directory

Locations

400 S Beverly Dr
Ste 380
Beverly Hills, CA 90212
Phone (424) 285-0999

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": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1902676695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 S SPAULDING AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364608",
            "telephone_number": "415-802-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BEVERLY DR STE 380",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124424",
            "telephone_number": "415-802-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHARA AIVAZ MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "AIVAZ",
        "authorized_official_first_name": "OHARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-802-1310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.