Individual provider Active NPI

Sohrab Salamatipour, MD

  • Specialist
  • Orange, CA
National Provider Identifier
1003957077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A63781 Issued in CA
Practice address
775 N Tustin St
Orange, CA 92867-7128
Phone
(714) 628-8888
Fax
(714) 538-2124
NPI assigned
Feb 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A63781 CA Primary

Addresses

Primary practice location

775 N Tustin St
Orange, CA 92867-7128

Mailing address

775 N Tustin St
Orange, CA 92867-7128
Phone (714) 628-8888

Other identifiers 1

IdentifierTypeStateIssuer
00A637810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050223000503 CA Practitioner - Pediatric Medicine 9739132325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holt Medical CorporationGroup PAC ID 7517025174, 2 clinicians

Practice addresses (Care Compare)

5153 Holt Blvd
Suite B1
Montclair, CA 91763-4837
Phone (909) 603-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A63781CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Medical Group Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003957077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677128",
            "telephone_number": "714-628-8888",
            "fax_number": "714-538-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 N TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677128",
            "telephone_number": "714-628-8888",
            "fax_number": "714-538-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMATIPOUR",
        "first_name": "SOHRAB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A63781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A637810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.