Abdolrasool Ebrahimi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C405200 Issued in CA

Practice address

575 E Hardy Street
Suite 221
Inglewood, CA 90301

Phone

(310) 677-9131

Fax

(310) 544-7262

NPI assigned

Jul 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fatema a Shamim MD Inc

  • Pediatrics Physician
  • Inglewood, CA
  • NPI 1114352812
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114933314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6390 CHARTRES DR",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "90275",
            "telephone_number": "310-677-9131",
            "fax_number": "310-677-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY STREET",
            "address_2": "SUITE 221",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "90301",
            "telephone_number": "310-677-9131",
            "fax_number": "310-544-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMI",
        "first_name": "ABDOLRASOOL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C405200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00C405200",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C405200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DW Medical Supply, Inc.
• Marilyn Denise Dyson, IMFT
• E Medical Transportation LLC
• Francine Nicole Eager
• East Centinela Valley Care Inc (Centinela Valley Care Center East)
• Kaelyn Echave
• Brenda R Echols
• Coral Dabarera Edelson, MS, RD
• Eden Garden West, Inc. Medical Supply
• Herbert Edmonds Jr.

• Pediatrics Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Pediatrics Physician in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.