Individual provider Active NPI

Leyla Mehdizadegan, D.C., L.AC

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1912283888
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
31507 Issued in CA
Practice address
5232 E Beverly Blvd
Los Angeles, CA 90022-2002
Phone
(323) 724-6911
NPI assigned
Oct 24, 2011
Last updated
Mar 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31507 CA Primary
Acupuncturist 171100000X 14423 CA

Addresses

Primary practice location

5232 E Beverly Blvd
Los Angeles, CA 90022-2002

Mailing address

1000 San Gabriel Blvd
Ste 200
Rosemead, CA 91770-4394
Phone (323) 724-0019

Other names 1

  • Dr. Leyla Mehdizadegan Other name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401002159 CA Practitioner - ChiropracticPractitioner - Other (Physician) 6103255849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31507CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central City Community Health Center Inc CurrentSince Feb 12, 2020 Accepting new patients
Central City Community Health Center Inc Current Accepting new patients
Central City Community Health Center Inc CurrentSince Feb 12, 2020 Accepting new patients
Gilbert Varela, M.D Inc. PastSince Oct 28, 2016 Accepting new patients

Locations

2237 W Ball Rd
Anaheim, CA 92804
Phone (714) 490-2750

4126 Maine Ave
Baldwin Park, CA 91706
Phone (626) 653-0800

12511 Brookhurst St
Garden Grove, CA 92840
Phone (714) 534-5050

13742 Amar Rd
La Puente, CA 91746
Phone (626) 919-0400

5970 S Central Ave
Los Angeles, CA 90001
Phone (213) 234-3280

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1000 San Gabriel Blvd
Ste 200
Rosemead, CA 91770
Phone (323) 724-0019

12116 Beach Blvd
Stanton, CA 90680
Phone (714) 498-2222

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.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1912283888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SAN GABRIEL BLVD",
            "address_2": "STE 200",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917704394",
            "telephone_number": "323-724-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5232 E BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222002",
            "telephone_number": "323-724-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHDIZADEGAN",
        "first_name": "LEYLA",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31507",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "14423",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEYLA",
            "last_name": "MEHDIZADEGAN",
            "prefix": "DR.",
            "credential": "D.C., L.AC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.