Individual provider Active NPI

Ali Goharbin, MD.

  • Family Medicine Physician
  • Porter Ranch, CA
National Provider Identifier
1235411844
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A117121 Issued in CA
Practice address
19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone
(818) 403-2400
NPI assigned
Sep 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A117121 CA Primary

Addresses

Primary practice location

19950 Rinaldi St
Porter Ranch, CA 91326-4141

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

Other identifiers 1

IdentifierTypeStateIssuer
00A1171210MedicaidCA

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
I20120507000676 CA Practitioner - Family Practice 3779745856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

14550 Soledad Canyon Rd
Canyon Country, CA 91387-2200
Phone (661) 250-5200

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

26357 McBean Pkwy
Valencia, CA 91355-4488
Phone (661) 222-2600

9111 Corbin Ave
Northridge, CA 91324-2402
Phone (818) 743-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117121CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince May 1, 2012 Accepting new patients
Providence Facey Medical Foundation Family Medicine CurrentSince May 1, 2012 Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 105
Porter Ranch, CA 91326

19950 Rinaldi St
Porter Ranch, CA 91326
Phone (818) 403-2400

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: agoharbin350313@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1235411844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19950 RINALDI ST",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913264141",
            "telephone_number": "818-403-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOHARBIN",
        "first_name": "ALI",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A1171210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Porter Ranch, CA

Sources for this page

Verify at the official NPI Registry.