Individual provider Active NPI

Arash Khosrovi-Eghbal, M.D.

  • Internal Medicine Physician
  • Bakersfield, CA
National Provider Identifier
1164873840
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A157669 Issued in CA
Practice address
2400 Wible Rd Ste 14
Bakersfield, CA 93304-4734
Phone
(661) 835-1240
Fax
(661) 835-4667
NPI assigned
Jun 24, 2016
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61434850 WA
Internal Medicine Physician 207R00000X A157669 CA Primary

Addresses

Primary practice location

2400 Wible Rd Ste 14
Bakersfield, CA 93304-4734

Mailing address

2400 Wible Rd Ste 14
Bakersfield, CA 93304-4734
Phone (661) 835-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230810002558 WA Practitioner - Internal Medicine 7517295033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

1901 S Union Ave
Tacoma, WA 98405-1702
Phone (253) 459-6633

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157669CAMDInternal Medicine Physician
MD61434850WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 4, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jul 4, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1164873840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WIBLE RD STE 14",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933044734",
            "telephone_number": "661-835-1240",
            "fax_number": "661-835-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 WIBLE RD STE 14",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933044734",
            "telephone_number": "661-835-1240",
            "fax_number": "661-835-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSROVI-EGHBAL",
        "first_name": "ARASH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61434850",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.