Etehad M.D., Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ETEHAD M.D., INC

Practice address

7667 Winnetka Ave
Winnetka, CA 91306-2677

Phone

(818) 812-9466

NPI assigned

Mar 19, 2019

Last updated

Mar 19, 2019By 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

Siamak P Etehad, MD

Title

President

Phone

(818) 812-9466

Specialties & licenses 1

Addresses

Tax ID family

Etehad MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Etehad M.D., Inc

  • Non-Pharmacy Dispensing Site
  • Winnetka, CA
  • NPI 1891341871
  NPD tax ID

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1144789975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7667 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7667 WINNETKA AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062677",
            "telephone_number": "818-812-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETEHAD M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "ETEHAD",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-812-9466",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Winnetka, CA
• Providers in Winnetka, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.

Verify at the official NPI Registry.