Individual provider Active NPI

Sevak E. Khodabakhshian, D.C.

  • Rehabilitation Chiropractor
  • Thousand Oaks, CA
National Provider Identifier
1043398589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC22785 Issued in CA
Practice address
325 Rolling Oaks Dr Ste 250
Thousand Oaks, CA 91361-1087
Phone
(805) 230-2673
Fax
(805) 230-2134
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X DC22785 CA Primary

Addresses

Primary practice location

325 Rolling Oaks Dr Ste 250
Thousand Oaks, CA 91361-1087

Mailing address

325 Rolling Oaks Dr Ste 250
Thousand Oaks, CA 91361-1087
Phone (805) 230-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000635 CA Practitioner - Chiropractic 2668561440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Khodabakhshian Chiropractic IncGroup PAC ID 5294824082, 5 clinicians

Practice addresses (Care Compare)

325 E Rolling Oaks Dr
Thousand Oaks, CA 91361-1087
Phone (805) 230-1199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC22785CAMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Khodabakhshian Chiropractic Inc Rehabilitation CurrentSince Jan 1, 2007 Accepting new patients

Locations

325 Rolling Oaks Dr
Ste 250
Thousand Oaks, CA 91361
Phone (805) 230-1199

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043398589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 ROLLING OAKS DR STE 250",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611087",
            "telephone_number": "805-230-2673",
            "fax_number": "805-230-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 ROLLING OAKS DR STE 250",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611087",
            "telephone_number": "805-230-2673",
            "fax_number": "805-230-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODABAKHSHIAN",
        "first_name": "SEVAK",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC22785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.