NPIMap

Organization Active NPI

Behnam Ebrahimi MD Inc

  • Hematology & Oncology Physician
  • Pomona, CA
National Provider Identifier
1447813332
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
BEHNAM EBRAHIMI MD INC
Practice address
1910 Royalty Dr
Pomona, CA 91767-3021
Phone
(909) 630-7342
Fax
(909) 630-7299
NPI assigned
Apr 17, 2019
Last updated
Jun 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Dr. Behnam Ebrahimi, MDNPI 1033165139
Title
President
Phone
(909) 865-9500

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)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

1910 Royalty Dr
Pomona, CA 91767-3021

Mailing address

1910 Royalty Dr
Pomona, CA 91767-3021
Phone (602) 441-9520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190712000629 CA Part B Supplier - Clinic/Group Practice 7214262260 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: San Dimas, CA; Chino, CA; West Covina, CA; Upland, CA; Rancho Cucamonga, CA; Pomona, CA; Ontario, CA; Montclair, CA…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1447813332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ROYALTY DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673021",
            "telephone_number": "602-441-9520",
            "fax_number": "602-441-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ROYALTY DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673021",
            "telephone_number": "909-630-7342",
            "fax_number": "909-630-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHNAM EBRAHIMI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI",
        "authorized_official_first_name": "BEHNAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-865-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.

Verify at the official NPI Registry.