Azadeh Modaresi, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A70235 Issued in CA

Practice address

6730A White Oak Ave
Van Nuys, CA 91406

Phone

(818) 668-8898

Fax

(818) 668-8893

NPI assigned

Jun 1, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sunrise Cosmed, a Medical Corporation

  • Clinic/Center
  • Van Nuys, CA
  • NPI 1679626733

  Internal Medicine

  NPD (past) Authorized official
• Lakeside Medical Associates, a Medical Group, Inc.

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1932129434

  Internal Medicine

  NPD (past)
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992707004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913650547",
            "telephone_number": "818-668-8898",
            "fax_number": "918-668-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6730A WHITE OAK AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91406",
            "telephone_number": "818-668-8898",
            "fax_number": "818-668-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODARESI",
        "first_name": "AZADEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A70235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A70235",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ripsime Mkrtchian
• MLS Medical Group
• Mobile Medics Group LLC
• Briani Mobley
• Francisco Moctezuma Vizcaino
• Modern Age Home Health, Inc.
• Modern Age Hospice, Imc.
• Modern Day Home Health Care Inc
• Mehdi Amini Moghadam, MID
• Bahman Moghaddas

• Internal Medicine Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.