Dr. Nasser Redjal M.D. a Professional Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

A41807 Issued in CA

Legal business name

DR. NASSER REDJAL M.D. A PROFESSIONAL CORPORATION

Practice address

15243 Vanowen St
Ste. 304
Van Nuys, CA 91405-3605

Phone

(818) 782-2332

Fax

(818) 782-2333

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nasser Redjal, M.D.

Title

President

Phone

(818) 782-2332

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1962686477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "STE. 304",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15243 VANOWEN ST",
            "address_2": "STE. 304",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053605",
            "telephone_number": "818-782-2332",
            "fax_number": "818-782-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NASSER REDJAL M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "REDJAL",
        "authorized_official_first_name": "NASSER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-782-2332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A41807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A418071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.