Active NPI
Amir Mansourian, M.D.
- Urology Physician
- Concord, CA
National Provider Identifier
1356436612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- C388522
- Practice address
- 1278 N Montecito Dr
Concord, CA 94521-5510 - Phone
- (925) 753-1986
- NPI assigned
- Oct 4, 2006
- Reactivated
- Jul 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | C388522 | CA | Primary |
Addresses
Primary practice location
1278 N Montecito Dr
Concord, CA 94521-5510
Mailing address
PO Box 31592
Walnut Creek, CA 94598-8592
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C388522 | CA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1356436612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31592",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945988592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1278 N MONTECITO DR",
"city": "CONCORD",
"state": "CA",
"postal_code": "945215510",
"telephone_number": "925-753-1986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSOURIAN",
"first_name": "AMIR",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2015-07-16",
"deactivation_date": "2013-09-10",
"reactivation_date": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "C388522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.