Aviccenna Medical Group

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A100198 Issued in CA

Legal business name

AVICCENNA MEDICAL GROUP

Practice address

435 N Bedford Dr
Suite # 312
Beverly Hills, CA 90210-4321

Phone

(310) 858-1800

NPI assigned

Jan 5, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Seyed Farhad N Chimeh, MDNPI 1306820220

Title

President

Phone

(310) 858-1800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Seyed Farhad N Chimeh, M.D.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1306820220
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1124264635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3392 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343712",
            "telephone_number": "310-858-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N BEDFORD DR",
            "address_2": "SUITE # 312",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104321",
            "telephone_number": "310-858-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVICCENNA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "CHIMEH",
        "authorized_official_first_name": "SEYED FARHAD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-858-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A100198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2074290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Julia Axelrod

• Nephrology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.