Bahram Marzban, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27191 Issued in CA

Practice address

22482 Rippling BRK
Lake Forest, CA 92630-5625

Phone

(949) 350-3661

NPI assigned

May 26, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shilpa Diwan MD IncGroup PAC ID 5890023980, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shilpa Diwan MD Inc

  • Psychiatry Physician
  • Irvine, CA
  • NPI 1902458524
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1427437243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22482 RIPPLING BRK",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22482 RIPPLING BRK",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305625",
            "telephone_number": "949-350-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZBAN",
        "first_name": "BAHRAM",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Martinez
• Lilly Martinez
• Monica Cristina Martinez
• Mary R Pham DDS Dental Corporation
• Maryam Waheed Dental Group Corp
• John Massoud, ATC, LMP, NCTM
• Michelle Ashley Mata
• McKenna Ann Mattice, MSN, FNP
• Sheryl Mattson
• Maxrelax Zen Inc.

• Clinical Psychologist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.