NPIMap

Organization Active NPI

Neurosurgical Trauma Services

  • Specialist
  • Roseville, CA
National Provider Identifier
1104963834
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEUROSURGICAL TRAUMA SERVICES
Practice address
1301 Secret Ravine Pkwy
Ste 200
Roseville, CA 95661-3096
Phone
(916) 771-3393
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Bahram Chehrazi, MDNPI 1346226685
Title
Medical Director
Phone
(916) 771-3393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1301 Secret Ravine Pkwy
Ste 200
Roseville, CA 95661-3096

Mailing address

PO Box 2600
Granite Bay, CA 95746-2600
Phone (916) 771-3393

Other identifiers 2

IdentifierTypeStateIssuer
GR0070590MedicaidCA
ZZZ49984ZOtherCABLUE SHIELD GROUP ID

National Provider Directory

National Provider Directory

Locations

File 73080
San Francisco, CA 94160

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1104963834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2600",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957462600",
            "telephone_number": "916-771-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SECRET RAVINE PKWY",
            "address_2": "STE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613096",
            "telephone_number": "916-771-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGICAL TRAUMA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "CHEHRAZI",
        "authorized_official_first_name": "BAHRAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-771-3393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0070590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP ID",
            "identifier": "ZZZ49984Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.