Individual provider Active NPI

Shiva Eshaghian, PA

  • Medical Physician Assistant
  • Beverly Hills, CA
National Provider Identifier
1396071908
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
20575 Issued in CA
Practice address
450 N. Bedord Dr. Ste 209
Beverly Hills, CA 90210-4306
Phone
(516) 404-5109
Fax
(323) 370-6817
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 20575 CA Primary

Addresses

Primary practice location

450 N. Bedord Dr. Ste 209
Beverly Hills, CA 90210-4306

Mailing address

16661 Ventura Blvd
Ste 824
Encino, CA 91436-4802
Phone (818) 784-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100212000566 CA Practitioner - Physician Assistant 3173667219 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20575CAMDAcupuncturist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1396071908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD",
            "address_2": "STE 824",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364802",
            "telephone_number": "818-784-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N. BEDORD DR. STE 209",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104306",
            "telephone_number": "516-404-5109",
            "fax_number": "323-370-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHAGHIAN",
        "first_name": "SHIVA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "20575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.