Individual provider Active NPI

Khashayar Sarabi, M.D.

  • General Practice Physician
  • Irvine, CA
National Provider Identifier
1467650846
Registry record updated Nov 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A105478 Issued in CA
Practice address
250 E Yale Loop Ste E
Irvine, CA 92604-4697
Phone
(310) 893-3884
NPI assigned
Jul 6, 2007
Last updated
Nov 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2023

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 A105478 CA Primary

Addresses

Primary practice location

250 E Yale Loop Ste E
Irvine, CA 92604-4697

Mailing address

1512 Treasure LN
Santa Ana, CA 92705-2463
Phone (310) 893-3884

Other practice location 1

2572 Atlantic Ave
Long Beach, CA 90806-2751
Phone (310) 893-3884

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508001917 CA Practitioner - General Practice 7618219841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
George Washington University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West la Medical GroupGroup PAC ID 1658735568, 4 clinicians

Practice addresses (Care Compare)

2572 Atlantic Ave
Long Beach, CA 90806-2751
Phone (818) 774-2755

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105478CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West la Medical Group CurrentSince Oct 1, 2024 Accepting new patients
Imperial Valley Family Care Medical Group Apc General Practice Past Accepting new patients
Prestige Surgical Center LLC PastSince Jul 1, 2023 Accepting new patients

Locations

17609 Ventura Blvd
Ste LL08
Encino, CA 91316
Phone (818) 774-2755

2572 Atlantic Ave
Long Beach, CA 90806
Phone (562) 424-0931

9220 Haven Ave
Ste 320
Rch Cucamonga, CA 91730
Phone (818) 774-2755

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1467650846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 TREASURE LN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052463",
            "telephone_number": "310-893-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E YALE LOOP STE E",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044697",
            "telephone_number": "310-893-3884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2572 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908062751",
            "country_code": "US",
            "telephone_number": "310-893-3884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARABI",
        "first_name": "KHASHAYAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A105478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.