Individual provider Active NPI

Alex Eshaghian, MD, PHD

  • Dermatology Physician
  • Encino, CA
National Provider Identifier
1154582641
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A110726 Issued in CA
Practice address
16311 Ventura Blvd Ste 845
Encino, CA 91436-4330
Phone
(818) 835-1833
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A110726 CA Primary

Addresses

Primary practice location

16311 Ventura Blvd Ste 845
Encino, CA 91436-4330

Mailing address

16311 Ventura Blvd
845
Encino, CA 91436-8025
Phone (818) 835-1833

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://mdwareonline.com/aeskin/sign-in Health Information Exchange (HIE)

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)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
A110726CAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1154582641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "845",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914368025",
            "telephone_number": "818-835-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 845",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364330",
            "telephone_number": "818-835-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHAGHIAN",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A110726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://mdwareonline.com/aeskin/sign-in",
            "affiliation": "N",
            "endpointDescription": "patient portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "16311 Ventura Blvd Ste 845",
            "city": "Encino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914364330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.