Abbas Mahdavi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A31325 Issued in CA

Practice address

3700 Lone Tree Way # 3
Antioch, CA 94509-6018

Phone

(925) 754-7200

NPI assigned

Aug 5, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Abbas Mahdavi MD Inc

  • Pediatrics Physician
  • Antioch, CA
  • NPI 1861800633
  NPD (past) Authorized official
• Sutter East Bay Medical Foundation

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1831381623
  NPD (past)

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1194134049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 LONE TREE WAY # 3",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096018",
            "telephone_number": "925-754-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 LONE TREE WAY # 3",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096018",
            "telephone_number": "925-754-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHDAVI",
        "first_name": "ABBAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A31325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A313250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewelyn Madrigal
• Sherwin Magalued, LVN
• Nympha Magat, PTA
• Karen D Mahan
• Elina Maharjan, FNP-BC
• Anthony Maher, PHARM.D.
• Marjo Ignacio Malano, PHYSICAL THERAPIST
• Beverly Miriam Maldonado, CNM
• Vincent Malfitano
• Mary-Ann Malik, MD

• Pediatrics Physician in Antioch, CA
• Providers in Antioch, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.