| |
9200 W Pico Blvd Los Angeles CA 90035-1319 | |
(310) 274-9500 | |
(310) 274-7018 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 9200 W Pico Blvd, Los Angeles, California |
Authorized Official Name and Position | Michael Katiraie (D.O./PRESIDENT) |
Authorized Official Contact | 3102749500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
9200 W Pico Blvd Los Angeles CA 90035-1319 Ph: (310) 274-9500 | 9200 W Pico Blvd Los Angeles CA 90035-1319 Ph: (310) 274-9500 |
NPI Number | 1518570290 |
---|---|
Provider Enumeration Date | 08/24/2020 |
Last Update Date | 02/09/2024 |
Medicare PECOS PAC ID | 5092121251 |
---|---|
Medicare Enrollment ID | O20210312001101 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518570290 | NPI | - | NPPES |
20A16783 | Other | CA | LIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Ajmal Mohammad |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700017712 PECOS PAC ID: 2365570504 Enrollment ID: I20100510000669 |
Provider Name | Michael Katiraie |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1730617994 PECOS PAC ID: 2567700859 Enrollment ID: I20190212001403 |
Provider Name | Aziz A Rasooli |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1194295469 PECOS PAC ID: 2769722024 Enrollment ID: I20190322001852 |
Provider Name | Ramon T Pacina |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407434004 PECOS PAC ID: 2466855713 Enrollment ID: I20210723000919 |
Provider Name | Marco Juarez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295490209 PECOS PAC ID: 6204125438 Enrollment ID: I20220126002323 |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |