Active NPI
Nafiseh Moghadam, P.A.
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1922023084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17768
- Practice address
- 8405 Beverly Blvd
Los Angeles, CA 90048-3401 - Phone
- (323) 385-3005
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17768 | CA | Primary |
Addresses
Primary practice location
8405 Beverly Blvd
Los Angeles, CA 90048-3401
Mailing address
PO Box 115
S Pasadena, CA 91031-0115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17768 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922023084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 115",
"city": "S PASADENA",
"state": "CA",
"postal_code": "910310115"
},
{
"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": "323-385-3005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADAM",
"first_name": "NAFISEH",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.