Individual provider Active NPI

Ali Asghar Behzadnia, MD FACP

  • Endocrinology, Diabetes & Metabolism Physician
  • Costa Mesa, CA
National Provider Identifier
1245318088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A39541 Issued in CA
Practice address
275 Victoria St
#2J
Costa Mesa, CA 92627
Phone
(949) 650-0630
Fax
(949) 650-3754
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A39541 CA Primary

Addresses

Primary practice location

275 Victoria St
#2J
Costa Mesa, CA 92627

Mailing address

275 Victoria St
#2J
Costa Mesa, CA 92627
Phone (949) 650-0630

Other identifiers 1

IdentifierTypeStateIssuer
00A395410MedicaidCA

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
I20040319000511 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 4587554753 Practice locations: Costa Mesa, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A39541CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew M. DO. DPM a Proffesional Corporation Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245318088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 VICTORIA ST",
            "address_2": "#2J",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-650-0630",
            "fax_number": "949-650-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VICTORIA ST",
            "address_2": "#2J",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92627",
            "telephone_number": "949-650-0630",
            "fax_number": "949-650-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHZADNIA",
        "first_name": "ALI",
        "middle_name": "ASGHAR",
        "credential": "MD FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A39541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A395410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.