Organization Active NPI

Djamshid Moshirnia, M.D., Inc.

  • Nephrology Physician
  • Stockton, CA
National Provider Identifier
1164544508
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A33715 Issued in CA
Legal business name
DJAMSHID MOSHIRNIA, M.D., INC.
Practice address
555 W Benjamin Holt Dr Ste 200a
Stockton, CA 95207-3839
Phone
(209) 943-0168
Fax
(209) 943-0416
NPI assigned
Apr 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Dr. Djamshid Moshirnia, M.D.
Title
Owner
Phone
(209) 943-0168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X A33715 CA Primary

Addresses

Primary practice location

555 W Benjamin Holt Dr Ste 200a
Stockton, CA 95207-3839

Mailing address

555 W Benjamin Holt Dr Ste 200a
Stockton, CA 95207-3839
Phone (209) 943-0168

Other identifiers 1

IdentifierTypeStateIssuer
00A337150MedicaidCA

National Provider Directory

National Provider Directory

Locations

555 W Benjamin Holt Dr
Ste 200A
Stockton, CA 95207
Phone (209) 943-0168

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1164544508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR STE 200A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839",
            "telephone_number": "209-943-0168",
            "fax_number": "209-943-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR STE 200A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839",
            "telephone_number": "209-943-0168",
            "fax_number": "209-943-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DJAMSHID MOSHIRNIA, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "MOSHIRNIA",
        "authorized_official_first_name": "DJAMSHID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-943-0168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A33715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A337150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.