Active NPI
Iradj Nabatian, MD
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1073689113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A55354
- Practice address
- 4533 College Avenue
San Diego, CA 92115 - Phone
- (619) 286-3355
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A55354 | CA | Primary |
Addresses
Primary practice location
4533 College Avenue
San Diego, CA 92115
Mailing address
4533 College Avenue
San Diego, CA 92115
Phone (619) 286-3355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A55354 | Medicaid | CA |
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 |
|---|---|---|---|---|
| I20060425000355 | CA | Practitioner - Psychiatry | 1153331913 | Practice locations: Los Angeles, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073689113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4533 COLLEGE AVENUE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92115",
"telephone_number": "619-286-3355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4533 COLLEGE AVENUE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92115",
"telephone_number": "619-286-3355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NABATIAN",
"first_name": "IRADJ",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A55354",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A55354",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, 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; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.