Active NPI
Gary G Ghahremani, M.D.
- Diagnostic Radiology Physician
- San Diego, CA
National Provider Identifier
1114959798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- C50431
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (800) 926-8273
- NPI assigned
- Jul 6, 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | C50431 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
PO Box 232410
San Diego, CA 92193-2410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C504310 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C50431 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1114959798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 232410",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921932410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "800-926-8273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAHREMANI",
"first_name": "GARY",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "C50431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C504310",
"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 Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.