ALEX A. KHADAVI MD INC (NPI# 1043545957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043545957 |
| Entity Type | Organization |
| Organization Name | ALEX A. KHADAVI MD INC |
| Practice Address |
16260 Ventura Blvd Suite 140 Encino CA 91436-5103 |
| Mailing Address |
8539 W Sunset Blvd Suite 4 Box 132 West Hollywood CA 90069-2334 |
| Practice Telephone | 8185282500 |
| Practice Fax Number | 8185282505 |
| Mailing Telephone | 6619747954 |
| Mailing Fax Number | 6619748365 |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |
| Authorized Official Name | CATHIE L BYERS (MEDICAL BILLING MANAGER) |
| Authorized Official Telephone | 6619747954 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| Street Address |
16260 VENTURA BLVD SUITE 140 |
| City | ENCINO |
| State | CA |
| Zip Code | 91436-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548254659 | Advanced Sleep Medicine Services Inc | Clinic/Center | 16260 Ventura Blvd, Suite 700, Encino, CA 91436-2203 | 2005-09-02 |
| 1003452863 | Gelbert G De Guzman | Occupational Therapy Assistant | 16260 Ventura Blvd, Encino, CA 91436-2203 | 2019-11-26 |
| 1700376571 | Ardeshir Pooshpas | Nurse Practitioner | 16260 Ventura Blvd, Encino, CA 91436 | 2018-05-16 |
| 1497270987 | Anastasia Andrew | Family Medicine | 16260 Ventura Blvd, Encino, CA 91436-2203 | 2017-08-07 |
| 1487101069 | Great Beginnings Surgery Center LLC | Clinic/Center | 16260 Ventura Blvd, Suite 220, Encino, CA 91436 | 2016-09-01 |
| 1205287364 | Western Fertility Institute, LLC | Specialist | 16260 Ventura Blvd, 210, Encino, CA 91436-2203 | 2016-06-29 |
| 1841640083 | South Pacific Rehab Services | Skilled Nursing Facility | 16260 Ventura Blvd, Suite 60, Encino, CA 91436-2203 | 2016-06-19 |
| 1982052684 | Lia Gedamu | Nurse Practitioner | 16260 Ventura Blvd, Ll-15, Encino, CA 91436-2203 | 2016-06-03 |
| 1477917375 | Felecia Brown | Occupational Therapist | 16260 Ventura Blvd, 600, Encino, CA 91436-2203 | 2016-04-07 |
| 1548621709 | Sara Hoffman | Occupational Therapist | 16260 Ventura Blvd, Encino, CA 91436-2203 | 2016-03-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405014 | Find Your Balance, Center for Growth & Change Inc. | Marriage & Family Therapist | 15720 Ventura Blvd Suite 603, Encino, CA 91436 | 2020-07-24 |
| 1396214482 | Maria Guadalupe Cruz | Behavior Technician | 16500 Ventura Blvd # 414, Encino, CA 91436 | 2018-11-19 |
| 1699277186 | Rodolfo Alavez Jimenez | Behavior Technician | 16500 Ventura Blvd., Suite 414, Encino, CA 91436 | 2018-03-01 |
| 1750891503 | Robert James Kim-farley | Preventive Medicine | 4037 Rogen Drive, Encino, CA 91436 | 2017-10-06 |
| 1528577871 | Julia Szpakiewicz | Marriage & Family Therapist | 16550 Ventura Blvd 318, Encino, CA 91436 | 2017-09-28 |
| 1457875452 | Jeffrey Proniloff | Dentist | 16680 Ashley Oaks, Encino, CA 91436 | 2017-08-01 |
| 1114449592 | Loren Lizeth Huerta | Specialist/Technologist | 16500 Ventura Blvd #414, Encino, CA 91436 | 2017-07-07 |
| 1538619838 | Gilbert Torres Jr. | Physical Therapist | 16260 Ventura Blvd # 600, Encino Medical Tower, Encino, CA 91436 | 2016-10-11 |
| 1417313529 | Nancy L Reynolds | Marriage & Family Therapist | 16055 Ventura Blvd #409, Encino, CA 91436 | 2016-01-05 |
| 1457716748 | Salvador Salgado | Behavioral Analyst | 16500 Ventura Blvd. Suite 414, Encino, CA 91436 | 2015-12-31 |
| Find all providers in zip 91436 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235269473 | Dermatology & Laser Medical Center Inc | Dermatology | 16260 Ventura Blvd, Suite 140, Encino, CA 91436-2203 | 2007-03-06 |
| 1578529806 | Stephen Friedman | Dermatology | 16255 Ventura Blvd, #120, Encino, CA 91436-2302 | 2006-04-25 |
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| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.