Benjamin Behroozan MD Inc

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

A41374 Issued in CA

Legal business name

BENJAMIN BEHROOZAN MD INC

Doing business as

GREAT CARE MEDICAL GROUP

Practice address

5255 W Sunset Blvd
Los Angeles, CA 90027-5716

Phone

(323) 463-7262

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Benjamin Behroozan, M.D.NPI 1750440681

Title

Medical Director

Phone

(323) 463-7262

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GREAT CARE MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Benjamin Behroozan M D Inc

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1639234362

  O20050204000133

  Same enrollment

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Behroozan, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1750440681
  NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1194949180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275716",
            "telephone_number": "323-463-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275716",
            "telephone_number": "323-463-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN BEHROOZAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "BEHROOZAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-463-7262",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A41374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0026800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREAT CARE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hospice and Palliative Medicine (Family Medicine) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.