Nimsha Thaver, D.O PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A9264 Issued in CA

Legal business name

NIMSHA THAVER, D.O PC

Practice address

1350 W 6TH St
Second Floor, Suite 7
San Pedro, CA 90732-3544

Phone

(310) 802-3219

Fax

(310) 831-3000

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Nimshavathani Thaver, D.ONPI 1053413682

Title

President

Phone

(310) 947-9517

Specialties & licenses 1

Addresses

Other names 1

• Nimsha Thaver, D.O. Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nimshavathani Thaver, D.O.

  • Family Medicine Physician
  • Springfield, PA
  • NPI 1053413682

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285680280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PASEO DE CASTANA",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756385",
            "telephone_number": "310-802-3219",
            "fax_number": "310-831-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W 6TH ST",
            "address_2": "SECOND FLOOR, SUITE 7",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323544",
            "telephone_number": "310-802-3219",
            "fax_number": "310-831-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIMSHA THAVER, D.O PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THAVER",
        "authorized_official_first_name": "NIMSHAVATHANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-947-9517",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nimsha Thaver, D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Nova Medical Center

• All providers in San Pedro, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.