NPIMap

Organization Active NPI

Khosro Vahid, M.D. a Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1205175775
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A42627 Issued in CA
Legal business name
KHOSRO VAHID, M.D. A MEDICAL CORPORATION
Practice address
2121 S San Pedro St
Suite E
Los Angeles, CA 90011-1160
Phone
(213) 742-0300
Fax
(213) 746-0044
NPI assigned
Feb 4, 2013
Last updated
Feb 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Mr. Khosro Vahid, M.D
Title
President
Phone
(213) 304-3742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A42627 CA Primary

Addresses

Primary practice location

2121 S San Pedro St
Suite E
Los Angeles, CA 90011-1160

Mailing address

2121 S San Pedro St
Suite E
Los Angeles, CA 90011-1160
Phone (213) 742-0300

Other identifiers 1

IdentifierTypeStateIssuer
00A426270MedicaidCA

National Provider Directory

National Provider Directory

Locations

2121 S San Pedro St
Los Angeles, CA 90011
Phone (210) 742-0300

2121 S San Pedro St
Ste E
Los Angeles, CA 90011
Phone (213) 742-0300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1205175775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S SAN PEDRO ST",
            "address_2": "SUITE E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111160",
            "telephone_number": "213-742-0300",
            "fax_number": "213-746-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S SAN PEDRO ST",
            "address_2": "SUITE E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111160",
            "telephone_number": "213-742-0300",
            "fax_number": "213-746-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHOSRO VAHID, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "VAHID",
        "authorized_official_first_name": "KHOSRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-304-3742",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A426270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.