Individual provider Active NPI

Naida Radjabova

  • Physical Therapist
  • Marina del Rey, CA
National Provider Identifier
1942794516
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294184 Issued in CA
Practice address
13914 Bora Bora Way Apt 222
Marina del Rey, CA 90292-6840
Phone
(310) 596-9362
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294184 CA Primary

Addresses

Primary practice location

13914 Bora Bora Way Apt 222
Marina del Rey, CA 90292-6840

Mailing address

13914 Bora Bora Way Apt 222
Marina del Rey, CA 90292-6840
Phone (310) 596-9362

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190122001061 CA Practitioner - Physical Therapist in Private Practice 9436496007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7325 Medical Ctr Dr
Suite 206
West Hills, CA 91307-4122
Phone (818) 340-3820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294184CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John Geary Inc. Physical Therapist CurrentSince Jan 1, 2024 Accepting new patients
Precision Occupational Medical Group, Inc. CurrentSince Oct 19, 2018 Accepting new patients
Southern California Sports Rehabilitation, Inc. CurrentSince Oct 19, 2018 Accepting new patients

Locations

1835 S La Cienega Blvd
#C
Los Angeles, CA 90035
Phone (310) 287-3711

1809 E Dyer Rd
Ste 311
Santa Ana, CA 92705
Phone (949) 863-0022

11627 Telegraph Rd
Ste 105
Santa Fe Springs, CA 90670
Phone (562) 948-4004

7325 Medical Center Dr
Ste 206
West Hills, CA 91307
Phone (818) 340-3820

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1942794516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13914 BORA BORA WAY APT 222",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926840",
            "telephone_number": "310-596-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13914 BORA BORA WAY APT 222",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926840",
            "telephone_number": "310-596-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADJABOVA",
        "first_name": "NAIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.