Individual provider Active NPI

Shahrad Behnam, MD

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1043487267
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A96639 Issued in CA
Practice address
155 N Fresno St
Fresno, CA 93701-2302
Phone
(559) 499-6479
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A96639 CA Primary

Addresses

Primary practice location

155 N Fresno St
Fresno, CA 93701-2302

Mailing address

155 N Fresno St
Fresno, CA 93701-2302
Phone (310) 433-4822

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
I20090105000415 CA Practitioner - Family Practice 5698838480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11669 Santa Monica Blvd
Suite 110
Los Angeles, CA 90025-2929
Phone (310) 237-8760

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96639CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Vitals, Medical Corporation Internal Medicine CurrentSince Jul 19, 2025 Accepting new patients
Dermatology and Hair Restoration Specialists,Inc. Current Accepting new patients
Dermatology and Hair Restoration Specialists,Inc. Internal Medicine CurrentSince Nov 1, 2009 Accepting new patients

Locations

11669 Santa Monica Blvd
Ste 110
Los Angeles, CA 90025
Phone (310) 237-8760

2825 Santa Monica Blvd
Ste 303A
Santa Monica, CA 90404
Phone (310) 315-4989

Organizations & group practices 3

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1043487267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "310-433-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-499-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHNAM",
        "first_name": "SHAHRAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A96639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.