NPIMap

Organization Active NPI

Advanced OB/GYN & Infertility Medical Group Inc

  • Specialist
  • Aliso Viejo, CA
National Provider Identifier
1154432607
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ADVANCED OB/GYN & INFERTILITY MEDICAL GROUP INC
Practice address
24502 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3033
Phone
(949) 362-1515
Fax
(949) 362-7548
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Kamran Ghodsian, MDNPI 1942204409
Title
President
Phone
(949) 362-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

24502 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3033

Mailing address

24502 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3033
Phone (949) 362-1515

Other identifiers 3

IdentifierTypeStateIssuer
GR0050350MedicaidCA
GR0050351MedicaidCA
ZZZ29048ZOtherCABLUE SHIELD PROVIDER #

Other names 1

  • ADVANCED OB/GYN MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1154432607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24502 PACIFIC PARK DR",
            "address_2": "SUITE 105",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563033",
            "telephone_number": "949-362-1515",
            "fax_number": "949-362-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24502 PACIFIC PARK DR",
            "address_2": "SUITE 105",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563033",
            "telephone_number": "949-362-1515",
            "fax_number": "949-362-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED OB/GYN & INFERTILITY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "GHODSIAN",
        "authorized_official_first_name": "KAMRAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-362-1515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0050350",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0050351",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "ZZZ29048Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED OB/GYN MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.