Shalom Pain Tretament Medical Ctr, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A50982 Issued in CA

Legal business name

SHALOM PAIN TRETAMENT MEDICAL CTR, INC.

Practice address

9663 Santa Monica Blvd
#683
Beverly Hills, CA 90210-4303

Phone

(310) 601-7302

Fax

(310) 601-7276

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Kourosh Noormand, MD

Title

Director

Phone

(310) 601-7302

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shalom Pain Treatment Medical Center Inc

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1598726531

  O20050502000231

  Same enrollment

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1023069804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 SANTA MONICA BLVD",
            "address_2": "#683",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104303",
            "telephone_number": "310-601-7302",
            "fax_number": "310-601-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 SANTA MONICA BLVD",
            "address_2": "#683",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104303",
            "telephone_number": "310-601-7302",
            "fax_number": "310-601-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM PAIN TRETAMENT MEDICAL CTR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "NOORMAND",
        "authorized_official_first_name": "KOUROSH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-601-7302",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A50982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.