NPIMap

Individual provider Active NPI

Mehran Sourehnissani, M.D.

  • Internal Medicine Physician
  • Inglewood, CA
National Provider Identifier
1992745285
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A68196 Issued in CA
Practice address
3451 W Century Blvd
B-1
Inglewood, CA 90303-1227
Phone
(310) 677-9400
Fax
(310) 677-9402
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A68196 CA Primary

Addresses

Primary practice location

3451 W Century Blvd
B-1
Inglewood, CA 90303-1227

Mailing address

3451 W Century Blvd
B-1
Inglewood, CA 90303-1227
Phone (310) 677-9400

Other identifiers 2

IdentifierTypeStateIssuer
00A681960MedicaidCA
WA68196DOtherCAWA68196D MEDICARE INDIVIDUAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000384 CA Practitioner - Internal Medicine 2365410727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Century Medical Center ,a Professional CorporationGroup PAC ID 8729056189, 2 clinicians
Centinela Hospitalist Medical Group IncGroup PAC ID 3274696810, 11 clinicians
Wound DoctorsGroup PAC ID 9032585088, 3 clinicians

Practice addresses (Care Compare)

3451 W Century Blvd
Suite B1
Inglewood, CA 90303-1228
Phone (310) 677-9400

555 E Hardy St
Inglewood, CA 90301-4011
Phone (310) 673-4660

575 E Hardy St
Suite 312
Inglewood, CA 90301-4050
Phone (844) 960-2673

Hospital & facility affiliations

  • CHS Homecare Home health agency, Signal Hill, CA, CCN 058078
  • Pioneer Home Health Services, Inc Home health agency, Pacoima, CA, CCN 059498
  • Yes to Care Home health agency, Glendale, CA, CCN 757061
  • Lavanda Home Health Care Agency, Inc Home health agency, Burbank, CA, CCN 058334
  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739
  • Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
  • California Hospital Medical Center la Hospital, Los Angeles, CA, CCN 050149
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625
  • Centinela Hospital Medical Ctr Inpatient rehabilitation facility, Inglewood, CA, CCN 05T739
  • Alvarado Care Center Nursing home, Los Angeles, CA, CCN 056157
  • Manchester Healthcare Center Nursing home, Los Angeles, CA, CCN 555273
  • Hawthorne Healthcare & Wellness Centre, LP Nursing home, Hawthorne, CA, CCN 555677
  • Rosecrans Care Center Nursing home, Gardena, CA, CCN 055072
  • Osage Healthcare & Wellness Centre Nursing home, Inglewood, CA, CCN 056143

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68196CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical Center ,a Professional Corporation CurrentSince Jul 1, 2004 Accepting new patients
Wound Doctors CurrentSince Oct 1, 2022 Accepting new patients
Dignity Community Care Past Accepting new patients
Max Franklin Lebow, a Medical Corporation Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Centinela Freeman Emergency Medical Associates Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients

Locations

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

575 E Hardy St
Ste 312
Inglewood, CA 90301
Phone (310) 590-2333

3451 W Century Blvd
Ste B1
Inglewood, CA 90303
Phone (310) 330-9000

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: chmc-msourehnissani@primehealthcare.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rockport Healthcare ServicesHawthorne, CA, CCN 555677 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2021
Oct 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1992745285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD",
            "address_2": "B-1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031227",
            "telephone_number": "310-677-9400",
            "fax_number": "310-677-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD",
            "address_2": "B-1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031227",
            "telephone_number": "310-677-9400",
            "fax_number": "310-677-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUREHNISSANI",
        "first_name": "MEHRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A68196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A681960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA68196D MEDICARE INDIVIDUAL NUMBER",
            "identifier": "WA68196D",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.