Medical Weight Loss Institute, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A76100 Issued in CA

Legal business name

MEDICAL WEIGHT LOSS INSTITUTE, INC.

Practice address

16952 Ventura Blvd Ste 200-B
Encino, CA 91316-4197

Phone

(818) 789-3964

Fax

(818) 789-3967

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Pejman Eli Shirazy, M.D.

Title

President / Owner

Phone

(818) 789-3964

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1013290634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD STE 200-B",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD STE 200-B",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL WEIGHT LOSS INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "SHIRAZY",
        "authorized_official_first_name": "PEJMAN",
        "authorized_official_middle_name": "ELI",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "818-789-3964",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A76100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Encino, CA
• Providers in Encino, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.