NPIMap

Individual provider Active NPI

Soleyman Mirakhor, MD

  • Psychiatry Physician
  • Ventura, CA
National Provider Identifier
1003864067
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C52017 Issued in CA
Practice address
120 N Ashwood Ave
Ventura, CA 93003-1810
Phone
(805) 667-2850
NPI assigned
May 4, 2006
Last updated
May 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C52017 CA Primary

Addresses

Primary practice location

120 N Ashwood Ave
Ventura, CA 93003-1810

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52017CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Counseling Services, S.C. Past Accepting new patients
Cornerstone Counseling Services, S.C. PastSince Sep 1, 2002 Accepting new patients
Hansen Therapy, LLC Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Powerback Rehabilitation LLC Past Accepting new patients
Powerback Rehabilitation LLC Past Accepting new patients

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1003864067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N ASHWOOD AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031810",
            "telephone_number": "805-667-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAKHOR",
        "first_name": "SOLEYMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.