Aeg Medical Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

AEG MEDICAL INC

Practice address

1626 Montana Ave Ste 629
Santa Monica, CA 90403-1808

Phone

(310) 974-8767

NPI assigned

Sep 18, 2025

Last updated

Sep 18, 2025By 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

Ali Golshan, MDNPI 1114183993

Title

Owner

Phone

(916) 342-6460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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.

• Ali Golshan, M.D.

  • Vascular & Interventional Radiology Physician
  • Beverly Hills, CA
  • NPI 1114183993
  Medicare reassignment NPD Authorized official
• Carl Virgil Belan Lazaro, PA-C

  • Physician Assistant
  • Long Beach, CA
  • NPI 1700642311
  NPD (past)
• William M Truong, FNP

  • Family Nurse Practitioner
  • Beverly Hills, CA
  • NPI 1932072097
  NPD (past)
• Matthew Butler, PA

  • Physician Assistant
  • Kearney, NE
  • NPI 1689075897
  NPD (past)

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1154293447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 MONTANA AVE STE 629",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 MONTANA AVE STE 629",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031808",
            "telephone_number": "310-974-8767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Old Eureka Way Ste 2H",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960010228",
            "country_code": "US",
            "telephone_number": "310-974-8767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AEG MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "GOLSHAN",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-342-6460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.