Shahab Mahboubian, DO, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

20A10721 Issued in CA

Legal business name

SHAHAB MAHBOUBIAN, DO, INC.

Practice address

10640 Riverside Dr
North Hollywood, CA 91602-2319

Phone

(818) 755-6500

Fax

(818) 755-8904

NPI assigned

Aug 16, 2012

Organization subpart

No

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

Authorized official

Name

Shahab Mahboubian, DONPI 1144439316

Title

President

Phone

(818) 209-6528

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahab Mahboubian, D.O.

  • Orthopaedic Surgery Physician
  • North Hollywood, CA
  • NPI 1144439316
  Medicare reassignment NPD Authorized official
• Chrestin Elisha, DPM

  • Foot & Ankle Surgery Podiatrist
  • Glendale, CA
  • NPI 1578188181
  Medicare reassignment NPD

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1033467428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10640 RIVERSIDE DR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022319",
            "telephone_number": "818-755-6500",
            "fax_number": "818-755-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 RIVERSIDE DR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022319",
            "telephone_number": "818-755-6500",
            "fax_number": "818-755-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHAB MAHBOUBIAN, DO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "MAHBOUBIAN",
        "authorized_official_first_name": "SHAHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-209-6528",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A10721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SFM Medical Group Inc
• SG Care Inc.
• Betty Shaby, NP
• Nesyah Shaesteh
• Katayoon Shafagh, DDS
• Shahangian Dental Corp.
• Bahram Shahangian, D.D.S.
• Bita Shahangian, D.D.S.
• Davit Shahbazyan
• Arlet Shamalian, D.O.

• Specialist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.