Active NPI
Pegah Mehdizadeh, DO
- Internal Medicine Physician
- Calabasas, CA
National Provider Identifier
1023101458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20A9367
- Practice address
- 3809 Paseo Primario
Calabasas, CA 91302-3057 - Phone
- (818) 922-5204
- NPI assigned
- Sep 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20A9367 | CA | Primary |
Addresses
Primary practice location
3809 Paseo Primario
Calabasas, CA 91302-3057
Mailing address
3809 Paseo Primario
Calabasas, CA 91302-3057
Phone (818) 922-5204
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080602000904 | CA | Practitioner - Internal Medicine | 6002986056 | Practice locations: Calabasas, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A9367 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616889600000",
"number": "1023101458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3809 PASEO PRIMARIO",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913023057",
"telephone_number": "818-922-5204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3809 PASEO PRIMARIO",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913023057",
"telephone_number": "818-922-5204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHDIZADEH",
"first_name": "PEGAH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-30",
"last_updated": "2021-03-28",
"certification_date": "2021-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "20A9367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calabasas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.