Individual provider Active NPI

Ernest Rasyidi, M.D.

  • Psychiatry Physician
  • West Hollywood, CA
National Provider Identifier
1962644997
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A106902 Issued in CA
Practice address
8700 Beverly Blvd
Thalians Building W-101
West Hollywood, CA 90048-1804
Phone
(310) 423-8287
NPI assigned
Apr 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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 A106902 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
Thalians Building W-101
West Hollywood, CA 90048-1804

Mailing address

8700 Beverly Blvd
Thalians Building W-101
West Hollywood, CA 90048-1804
Phone (310) 423-8287

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
I20120626000663 CA Practitioner - PsychiatryPractitioner - Addiction Medicine 7113182080 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106902CAMDGeneral Practice Dentistry
A106902CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Progressive Recovery Inc Psychiatry CurrentSince Aug 1, 2017 Accepting new patients

Locations

3350 W Ball Rd
Anaheim, CA 92804
Phone (714) 220-4533

18101 Von Karman Ave
Fl 3
Irvine, CA 92612

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

Organizations & group practices 1

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1962644997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "THALIANS BUILDING W-101",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "THALIANS BUILDING W-101",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASYIDI",
        "first_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A106902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.