Individual provider Active NPI

Ben Behrouz Mousavi, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1003230079
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A131983 Issued in CA
Practice address
7801 Mission Center CT Ste 105
San Diego, CA 92108-1314
Phone
(818) 625-7210
NPI assigned
Feb 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A131983 CA Primary

Addresses

Primary practice location

7801 Mission Center CT Ste 105
San Diego, CA 92108-1314

Mailing address

7801 Mission Center CT Ste 105
San Diego, CA 92108-1314
Phone (818) 625-7210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150122002277 CA Practitioner - Internal Medicine 9032433057 Reassigns benefits to 3 organizations
I20190220003459 HI Practitioner - Internal Medicine 9032433057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A131983CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NR Medical Associates Multi-Specialty CurrentSince May 1, 2015 Accepting new patients
KND Development 59 LLC Multi-Specialty Current Accepting new patients
Imperial Valley Multi-Specialty Medical Group, Inc. Multi-Specialty CurrentSince May 11, 2016 Accepting new patients
KND Development 59, LLC Multi-Specialty CurrentSince Oct 8, 2018 Accepting new patients
Theodore Affue M D Inc Multi-Specialty CurrentSince May 11, 2016 Accepting new patients
Sound Physicians of Hawaii Inc Multi-Specialty CurrentSince Dec 18, 2018 Accepting new patients
KND Development 59 LLC Multi-Specialty CurrentSince Oct 8, 2018 Accepting new patients

Locations

2061 Ross Ave
Ste A
El Centro, CA 92243
Phone (760) 205-1212

302 Washington St
San Diego, CA 92103
Phone (800) 790-0890

4940 El Cajon Blvd
San Diego, CA 92115
Phone (619) 543-4500

555 Washington St
San Diego, CA 92103
Phone (619) 260-8300

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1003230079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 MISSION CENTER CT STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081314",
            "telephone_number": "818-625-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 MISSION CENTER CT STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081314",
            "telephone_number": "818-625-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSAVI",
        "first_name": "BEN",
        "middle_name": "BEHROUZ",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-12",
        "last_updated": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A131983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.