Active NPI
Btla VI
- Cardiovascular Disease Physician
- San Diego, CA
National Provider Identifier
1417345091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- C58208
- Legal business name
- BTLA VI
- Practice address
- 5555 Reservoir Dr
Suite #209
San Diego, CA 92120-5134 - Phone
- (336) 414-6079
- NPI assigned
- Jan 5, 2015
- Last updated
- Jan 5, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Behzad Taghizadeh, M.D.
- Title
- Manager
- Phone
- (336) 414-6079
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | C58208 | CA | Primary |
Addresses
Primary practice location
5555 Reservoir Dr
Suite #209
San Diego, CA 92120-5134
Mailing address
5555 Reservoir Dr
Suite #209
San Diego, CA 92120-5134
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275514986 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
5555 Reservoir Dr
Ste 209
San Diego, CA 92120
Phone (619) 582-2404
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Cardiovascular Disease Physician
- El Cajon, CA
- NPI 1275514986
-
- Family Medicine Physician
- El Cajon, CA
- NPI 1447542659
-
- Cardiovascular Disease Physician
- San Diego, CA
- NPI 1477680551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1420416000000",
"number": "1417345091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"address_2": "SUITE #209",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 RESERVOIR DR",
"address_2": "SUITE #209",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921205134",
"telephone_number": "336-414-6079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BTLA VI",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-05",
"last_updated": "2015-01-05",
"status": "A",
"authorized_official_last_name": "TAGHIZADEH",
"authorized_official_first_name": "BEHZAD",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "336-414-6079",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "C58208",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1275514986",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.