Ata Daniel Rezvanpour, MD in Los Angeles, CA - Medicare Interventional Radiology

Ata Daniel Rezvanpour, MD is a medicare enrolled "Radiology - Vascular & Interventional Radiology" physician in Los Angeles, California. He graduated from medical school in 1972 and has 52 years of diverse experience with area of expertise as Interventional Radiology. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is 6041 Cadillac Ave, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at (323) 857-2000.

Ata Daniel Rezvanpour is licensed to practice in California (license number A36429) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841348711.

Contact Information

	Ata Daniel Rezvanpour, MD
	6041 Cadillac Ave, Los Angeles, CA 90034-1702
	(323) 857-2000
	(323) 857-2619

Map and Direction

Physician's Profile

Full Name	Ata Daniel Rezvanpour
Gender	Male
Speciality	Interventional Radiology
Experience	52 Years
Location	6041 Cadillac Ave, Los Angeles, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ata Daniel Rezvanpour graduated from medical school in 1972

NPI Data:

NPI Number: 1841348711
Provider Enumeration Date: 01/08/2007
Last Update Date: 11/22/2021

Medicare PECOS Information:

PECOS PAC ID: 0749227700
Enrollment ID: I20050411001328

Medical Identifiers

Medical identifiers for Ata Daniel Rezvanpour such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841348711	NPI	-	NPPES
00A364290	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0204X	Radiology - Vascular & Interventional Radiology	A36429 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Kaiser Foundation Hospital - West La	Los angeles, CA	Hospital
Kaiser Foundation Hospital Fontana/ontario	Fontana, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southern California Permanente Medical Group	6002729175	8172

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ata Daniel Rezvanpour allows following entities to bill medicare on his behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ata Daniel Rezvanpour is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ata Daniel Rezvanpour, MD 393 E Walnut St, 3rd Floor Phr Systems, Pasadena, CA 91188-0001 Ph: () -	Ata Daniel Rezvanpour, MD 6041 Cadillac Ave, Los Angeles, CA 90034-1702 Ph: (323) 857-2000

Reviews and Comments

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Ata Daniel Rezvanpour, MD - Medicare Interventional Radiology in Los Angeles, CA