L a Surgery-Colorectal Surgery Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

A78449 Issued in CA

Legal business name

L A SURGERY-COLORECTAL SURGERY INC

Practice address

5353 Balboa Blvd Ste 201
Encino, CA 91316-2865

Phone

(818) 783-7277

Fax

(818) 783-9607

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mohammad A Pourshahmir, MDNPI 1437187028

Title

President

Phone

(818) 205-3540

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Mohammad A Pourshahmir, M.D.

  • Surgery Physician
  • Encino, CA
  • NPI 1437187028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1356438204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W RIVERSIDE DR STE 110-2780",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054046",
            "telephone_number": "818-205-3540",
            "fax_number": "818-783-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD STE 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162865",
            "telephone_number": "818-783-7277",
            "fax_number": "818-783-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L A SURGERY-COLORECTAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "POURSHAHMIR",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-205-3540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A78449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Encino, CA
• Providers in Encino, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.