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IMAM NAZAR SANOUSI
NPI 1629870332
Student in an Organized Health Care Education/Training Program in Los Angeles, CA

Active since March 25, 2025PECOS Enrolled
1200 N STATE ST STE A7DS, LOS ANGELES, CA 90089(775) 420-9295 Get Directions Write a Review

NPPES record last updated: March 25, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Imam Nazar Sanousi NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMAM NAZAR SANOUSI (NPI 1629870332) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629870332
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameIMAM NAZAR SANOUSI
Location Address1200 N STATE ST STE A7DSLos Angeles, CA 90089-1001
Mailing Address1200 N State St Ste A7dsLos Angeles, CA 90089-1001 · (323) 409-7556
Phone(775) 420-9295
Sole ProprietorNo
Enumeration DateMarch 25, 2025
NPPES CertifiedMarch 25, 2025
✔ NPI 1629870332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1200 N STATE ST STE A7DS, Los Angeles, CA 90089
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Imam Nazar Sanousi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Imam Sanousi's NPI number?

The NPI number for Imam Sanousi is 1629870332. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Where is Imam Sanousi located?

Imam Sanousi practices at 1200 N State St Ste A7ds, Los Angeles, CA 90089. The listed phone number is (775) 420-9295.

What is Imam Sanousi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Imam Sanousi enrolled in Medicare?

Yes. Imam Sanousi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Imam Sanousi was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.