Organization Active NPI

Ebrahim Sajedi MD. Inc.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1376564484
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EBRAHIM SAJEDI MD. INC.
Practice address
2222 Santa Monica Blvd
Suite 404
Santa Monica, CA 90404-2304
Phone
(310) 828-1600
Fax
(310) 829-9362
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Ebrahim Sajedi, MD
Title
Director
Phone
(310) 828-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2222 Santa Monica Blvd
Suite 404
Santa Monica, CA 90404-2304

Mailing address

2222 Santa Monica Blvd
Suite 404
Santa Monica, CA 90404-2304
Phone (310) 828-1600

Other identifiers 1

IdentifierTypeStateIssuer
00A622640MedicaidCA

National Provider Directory

National Provider Directory

Locations

2222 Santa Monica Blvd
Ste 404
Santa Monica, CA 90404
Phone (310) 828-1600

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1376564484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SANTA MONICA BLVD",
            "address_2": "SUITE 404",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042304",
            "telephone_number": "310-828-1600",
            "fax_number": "310-829-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 SANTA MONICA BLVD",
            "address_2": "SUITE 404",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042304",
            "telephone_number": "310-828-1600",
            "fax_number": "310-829-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBRAHIM SAJEDI MD. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "SAJEDI",
        "authorized_official_first_name": "EBRAHIM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-828-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A622640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.