Individual provider Active NPI

Homeyra Masoumi, MD

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1427797695
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A116925 Issued in CA
Practice address
530 K St Unit 1116
San Diego, CA 92101-7063
Phone
(858) 775-1871
NPI assigned
Jun 3, 2022
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A116925 CA Primary

Addresses

Primary practice location

530 K St Unit 1116
San Diego, CA 92101-7063

Mailing address

530 K St Unit 1116
San Diego, CA 92101-7063
Phone (858) 775-1871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116925CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1427797695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 K ST UNIT 1116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017063",
            "telephone_number": "858-775-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 K ST UNIT 1116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017063",
            "telephone_number": "858-775-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOUMI",
        "first_name": "HOMEYRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A116925",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 3, 2022; 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.