Individual provider Active NPI

Vladimir Khalafian, M.D.

  • Psychiatry Physician
  • La Mesa, CA
National Provider Identifier
1164718367
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A124417 Issued in CA
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 354-0388
Fax
(844) 211-3274
NPI assigned
Jun 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A124417 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

PO Box 1770
La Mesa, CA 91944-1770
Phone (619) 354-0388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129000018 CA Practitioner - Psychiatry 9830413590 Reassigns benefits to 3 organizations
Practice locations: La Mesa, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
124417CAMDMarriage & Family Therapist
A124417CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Diego CurrentSince Jan 1, 2015 Accepting new patients
County of San Diego CurrentSince Jan 1, 2015 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Jul 1, 2015 Accepting new patients
County of San Diego Current Accepting new patients
Asana Integrated Medical Group PC Psychiatry CurrentSince May 14, 2019 Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1164718367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-354-0388",
            "fax_number": "844-211-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-354-0388",
            "fax_number": "844-211-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALAFIAN",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-26",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A124417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.