Organization Active NPI

Vital Lungs Associates of Southern California Inc

  • Pulmonary Disease Physician
  • Northridge, CA
National Provider Identifier
1922762806
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
VITAL LUNGS ASSOCIATES OF SOUTHERN CALIFORNIA INC
Practice address
18300 Roscoe Blvd
Northridge, CA 91325-4105
Phone
(818) 885-8500
NPI assigned
Oct 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Authorized official

Name
Dr. Ali Atabaki, M.D.NPI 1619105426
Title
Co-President
Phone
(626) 375-6431

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
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

18300 Roscoe Blvd
Northridge, CA 91325-4105

Mailing address

22543 Ventura Blvd Unit 220-117
Woodland Hills, CA 91364-1412
Phone (626) 375-6431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216003053 CA Part B Supplier - Clinic/Group Practice 1355732884 Receives reassigned benefits from 6 practitioners
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Locations

22543 Ventura Blvd
Unit 220117
Woodland Hills, CA 91364

Practitioners & affiliated clinicians

Practitioners 6

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": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1922762806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22543 VENTURA BLVD UNIT 220-117",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641412",
            "telephone_number": "626-375-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-885-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LUNGS ASSOCIATES OF SOUTHERN CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "ATABAKI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "626-375-6431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.