Organization Active NPI

Jassam MD PC

  • Neurology Physician
  • Newport Beach, CA
National Provider Identifier
1265025464
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
JASSAM MD PC
Practice address
520 Superior Ave Ste 205
Newport Beach, CA 92663-3667
Phone
(949) 764-1444
Fax
(949) 764-7398
NPI assigned
Feb 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Dr. Yasir Jassam, M.D.
Title
President
Phone
(947) 764-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

520 Superior Ave Ste 205
Newport Beach, CA 92663-3667

Mailing address

520 Superior Ave Ste 205
Newport Beach, CA 92663-3667
Phone (949) 764-1444

National Provider Directory

National Provider Directory

Locations

520 Superior Ave
Ste 205
Newport Beach, CA 92663
Phone (949) 650-2462

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1265025464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 205",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633667",
            "telephone_number": "949-764-1444",
            "fax_number": "949-764-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 205",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633667",
            "telephone_number": "949-764-1444",
            "fax_number": "949-764-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASSAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "JASSAM",
        "authorized_official_first_name": "YASIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "947-764-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.