Preferred Ipa of California, a Professional Medical Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PREFERRED IPA OF CALIFORNIA, A PROFESSIONAL MEDICAL CORPORATION

Practice address

1025 N Brand Blvd
Suite 100
Glendale, CA 91202-2950

Phone

(818) 265-0800

Fax

(818) 265-0804

NPI assigned

May 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Shadan Ghaemian, M.D.

Title

President

Phone

(818) 265-0800

Specialties & licenses 1

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1295992725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N BRAND BLVD",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022950",
            "telephone_number": "818-265-0800",
            "fax_number": "818-265-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N BRAND BLVD",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022950",
            "telephone_number": "818-265-0800",
            "fax_number": "818-265-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED IPA OF CALIFORNIA, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "GHAEMIAN",
        "authorized_official_first_name": "SHADAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-265-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.