Active NPI
Ilan Bazak, DPM
- Podiatrist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E3741
- Practice address
- 1121 N Fairfox Ave
Los Angeles, CA 90046 - Phone
- (323) 650-6363
- Fax
- (323) 650-4377
- NPI assigned
- May 22, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E3741 | CA | Primary |
Addresses
Primary practice location
1121 N Fairfox Ave
Los Angeles, CA 90046
Mailing address
1121 N Fairfox Ave
Los Angeles, CA 90046
Phone (323) 650-6363
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1121 N Fairfax Ave
West Hollywood, CA 90046-5306
Phone (323) 650-6363
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 112 |
| Removal of skin lesions | 28 |
| Removal of nail tissue | 649 |
| Removal or shaving of skin growth | 535 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E3741 | CA | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vascular Intervention Specialists Inc | Podiatrist | Current | Accepting new patients |
| Ilan Bazak DPM Professional Corp | Podiatrist | Current | Accepting new patients |
| Cha Hollywood Medical Center, LP | Past | Accepting new patients |
Locations
19231 Victory Blvd
Ste 155
Reseda, CA 91335
Phone (818) 457-4512
18375 Ventura Blvd
Tarzana, CA 91356
Phone (818) 422-5322
1121 N Fairfax Ave
West Hollywood, CA 90046
Phone (213) 650-6363
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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.
-
- Durable Medical Equipment & Medical Supplies
- West Hollywood, CA
- NPI 1396906111
Podiatrist
-
- Vascular & Interventional Radiology Physician
- Reseda, CA
- NPI 1063959310
Podiatrist
-
dba Hollywood Presbyterian Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1922033547
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
-
- General Acute Care Hospital
- West Hollywood, CA
- NPI 1891940326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1932153970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 N FAIRFOX AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90046",
"telephone_number": "323-650-6363",
"fax_number": "323-650-4377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 N FAIRFOX AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90046",
"telephone_number": "323-650-6363",
"fax_number": "323-650-4377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZAK",
"first_name": "ILAN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E3741",
"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 13, 2026; 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.