Dan Dardashti, MD Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A61457 Issued in CA

Legal business name

DAN DARDASHTI, MD INC.

Practice address

12626 Riverside Dr
Suite #506
Valley Village, CA 91607-3420

Phone

(818) 508-9190

Fax

(818) 508-1648

NPI assigned

Jun 25, 2006

Last updated

Jul 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan Elia Dardashti, MDNPI 1275537524

Title

President

Phone

(818) 508-9190

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dan E Dardashti, M.D.

  • Internal Medicine Physician
  • Valley Village, CA
  • NPI 1275537524
  Medicare reassignment NPD Authorized official
• Heidi Collier

  • Family Nurse Practitioner
  • Encino, CA
  • NPI 1003962010
  NPD (past)
• Edwin S Shulkin, MD

  • Internal Medicine Physician
  • North Hollywood, CA
  • NPI 1548285794
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1114953643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #506",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-508-9190",
            "fax_number": "818-508-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #506",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-508-9190",
            "fax_number": "818-508-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN DARDASHTI, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "DARDASHTI",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "ELIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-508-9190",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A61457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "00A614570",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A614570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dawn Marie Davolt, LCSW
• Jila Dayani, MD
• Joann De Virgilio

• Internal Medicine Physician in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.