Individual provider Active NPI

Adel Mostafavi, MD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1962526756
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A92472 Issued in CA
Practice address
801 S Grand Ave Ste 475
Los Angeles, CA 90017-4622
Phone
(310) 871-0670
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A92472 CA Primary

Addresses

Primary practice location

801 S Grand Ave Ste 475
Los Angeles, CA 90017-4622

Mailing address

13701 Riverside Dr
Suite 606
Sherman Oaks, CA 91423-2430
Phone (310) 871-0670

Other practice location 1

13701 Riverside Dr
Suite 606
Sherman Oaks, CA 91423-2430
Phone (310) 871-0670

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000259 CA Practitioner - Psychiatry 2466632633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Irvine, California College of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Medi Psych Services IncGroup PAC ID 3870908320, 17 clinicians

Practice addresses (Care Compare)

15260 Ventura Blvd
Suite 1200
Sherman Oaks, CA 91403-5347
Phone (310) 879-1097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A92472CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Well Psyche Medical Group Psychiatry Current Accepting new patients

Locations

1055 Wilshire Blvd
Ste 1705
Los Angeles, CA 90017
Phone (310) 871-0670

15260 Ventura Blvd
Ste 1200
Sherman Oaks, CA 91403
Phone (310) 871-0670

13701 Riverside Dr
Ste 606
Sherman Oaks, CA 91423
Phone (310) 871-0670

Organizations & group practices 2

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1962526756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 RIVERSIDE DR",
            "address_2": "SUITE 606",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232430",
            "telephone_number": "310-871-0670",
            "fax_number": "310-469-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S GRAND AVE STE 475",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174622",
            "telephone_number": "310-871-0670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13701 Riverside Dr",
            "address_2": "Suite 606",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914232430",
            "country_code": "US",
            "telephone_number": "310-871-0670",
            "fax_number": "310-469-7845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTAFAVI",
        "first_name": "ADEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A92472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.