Organization Active NPI

Tarzana Hospitalist Medical Corporation

  • Specialist
  • Tarzana, CA
National Provider Identifier
1255564944
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A61475 Issued in CA
Legal business name
TARZANA HOSPITALIST MEDICAL CORPORATION
Practice address
18399 Ventura Blvd
Suite 245
Tarzana, CA 91356-4233
Phone
(818) 609-7536
Fax
(818) 344-9670
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Authorized official

Name
Dr. Shahryar Thomas Yadegar, M.D.NPI 1174546493
Title
Officer
Phone
(818) 609-7536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X A61475 CA Primary

Addresses

Primary practice location

18399 Ventura Blvd
Suite 245
Tarzana, CA 91356-4233

Mailing address

18399 Ventura Blvd
Suite 245
Tarzana, CA 91356-4233
Phone (818) 609-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091222000707 CA Part B Supplier - Clinic/Group Practice 7810037868 Receives reassigned benefits from 6 practitioners
Practice locations: Tarzana, CA

National Provider Directory

National Provider Directory

Locations

18399 Ventura Blvd
Tarzana, CA 91356
Phone (818) 757-3200

Practitioners & affiliated clinicians

Practitioners 6

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": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1255564944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD",
            "address_2": "SUITE 245",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564233",
            "telephone_number": "818-609-7536",
            "fax_number": "818-344-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD",
            "address_2": "SUITE 245",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564233",
            "telephone_number": "818-609-7536",
            "fax_number": "818-344-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARZANA HOSPITALIST MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "YADEGAR",
        "authorized_official_first_name": "SHAHRYAR",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "818-609-7536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A61475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.