Provider Demographics
NPI:1518098730
Name:HEKMAT, JAMSHID J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMSHID
Middle Name:J
Last Name:HEKMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9763 W PICO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4748
Mailing Address - Country:US
Mailing Address - Phone:310-712-0000
Mailing Address - Fax:310-712-0012
Practice Address - Street 1:9763 W PICO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4748
Practice Address - Country:US
Practice Address - Phone:310-712-0000
Practice Address - Fax:310-712-0012
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32441207X00000X, 207XS0114X, 207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0021340Medicaid
CAA26803Medicare UPIN
CAGR0021340Medicaid