Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Emanouel Khodadadi, MSN-FNP-BC

Individual provider Family Nurse Practitioner · NPI 1477347193

Emanouel Khodadadi, MSN-FNP-BC is a Nurse Practitioner in Glendale, California. Graduated from University of Southern California Keck School of Medicine in 2024, 2 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
2
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2025

Practice location Address checks out

1818 Verdugo Blvd Ste 401
Glendale, CA 91208-1421
Phone: (818) 790-1145
Fax: (818) 790-6387
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP95032782 (CA)

Record details

NPI number1477347193
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN-FNP-BC
Sole proprietorYes
NPI enumeratedApril 7, 2025
Last updated in NPPESApril 7, 2025
Certification dateApril 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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