Individual provider Active NPI

Ashkan Etemadian, MD

  • Hospitalist Physician
  • Orange, CA
National Provider Identifier
1033355235
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A105385 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-8888
NPI assigned
Dec 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A105385 CA
Hospitalist Physician 208M00000X A105385 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

32565B Golden Lantern St # 167
Dana Point, CA 92629-3248

Other practice location 1

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 764-4624

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
I20101006000199 CA Practitioner - Internal Medicine 8426240680 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A105385CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Aug 15, 2015 Accepting new patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Mar 3, 2014 Accepting new patients
The Regents of the University of California-Irvine Hospitalist CurrentSince Aug 15, 2015 Accepting new patients
UC Regents Internal Medicine CurrentSince Aug 15, 2015 Accepting new patients
UC Regents Current Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1033355235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32565B GOLDEN LANTERN ST # 167",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hoag Dr",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926634162",
            "country_code": "US",
            "telephone_number": "949-764-4624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETEMADIAN",
        "first_name": "ASHKAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-18",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105385",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A105385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.