| Omid Benjamin Mehdizadeh, | |
|
2125 Arizona Ave, Santa Monica, CA 90404-1337 | |
| (310) 829-8701 | |
| (310) 315-4062 |
| Full Name | Omid Benjamin Mehdizadeh |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 13 Years |
| Location | 2125 Arizona Ave, Santa Monica, 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. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770816464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 150014 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Saint John's Health Center | Santa monica, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Saint Johns Medical Foundation | 0840548624 | 256 |
| Entity Name | Providence Saint Johns Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770093734 PECOS PAC ID: 0840548624 Enrollment ID: O20180810000904 |
| Mailing Address | Practice Location Address |
|---|---|
| Omid Benjamin Mehdizadeh, 2020 Santa Monica Blvd Fl 3, Santa Monica, CA 90404-2023 Ph: (310) 829-8868 | Omid Benjamin Mehdizadeh, 2125 Arizona Ave, Santa Monica, CA 90404-1337 Ph: (310) 829-8701 |
Andrew Alexander Mccall, Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1131 Wilshire Blvd Ste 302, Santa Monica, CA 90401 Phone: 424-259-6559 | |
Jivianne Kristine Tan Lee, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1131 Wilshire Blvd Ste 302, Santa Monica, CA 90401 Phone: 424-259-6559 Fax: 310-319-3877 | |
Cong Ran, Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1317 5th St Ste 300, Santa Monica, CA 90401 Phone: 310-434-0044 | |
Dr. Sheldon N. Klausner, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 2001 Santa Monica Blvd, Ste 870-w, Santa Monica, CA 90404 Phone: 310-829-1703 Fax: 310-494-9450 | |
Dr. Vivian F Wu, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1301 20th St Ste 300, Santa Monica, CA 90404 Phone: 310-829-7792 | |
Payam Daneshrad, MD Otolaryngology Medicare: May Accept Medicare Assignments Practice Location: 2811 Wilshire Blvd, Suite 800, Santa Monica, CA 90403 Phone: 310-306-3737 Fax: 310-306-1240 |