Individual provider Active NPI

Shahrad Rady Rahban, MD

  • Plastic Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1336173392
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A76662 Issued in CA
Practice address
152 S Lasky Dr Ste 100
Beverly Hills, CA 90212-1720
Phone
(310) 550-9985
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A76662 CA Primary

Addresses

Primary practice location

152 S Lasky Dr Ste 100
Beverly Hills, CA 90212-1720

Mailing address

152 S Lasky Dr Ste 100
Beverly Hills, CA 90212-1720
Phone (310) 550-9985

Other practice location 1

120 S Spalding Dr
Suite 222
Beverly Hills, CA 90212-1800
Phone (310) 550-9855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shahrad Rady Rahban, MD Inc CurrentSince Jan 1, 2010 Accepting new patients
Lasky Drive Surgery Center Plastic Surgery Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

152 S Lasky Dr
Ste 100
Beverly Hills, CA 90212
Phone (310) 550-9855

9730 Wilshire Blvd
Ste 215
Beverly Hills, CA 90212
Phone (310) 392-1111

Organizations & group practices 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1336173392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S LASKY DR STE 100",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121720",
            "telephone_number": "310-550-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S LASKY DR STE 100",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121720",
            "telephone_number": "310-550-9985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S Spalding Dr",
            "address_2": "Suite 222",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902121800",
            "country_code": "US",
            "telephone_number": "310-550-9855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHBAN",
        "first_name": "SHAHRAD",
        "middle_name": "RADY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A76662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.