Individual provider Active NPI

Pouyan Pouresfandiari, DO

  • Family Medicine Physician
  • Orange, CA
National Provider Identifier
1487348652
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A24205 Issued in CA
Practice address
615 E Chapman Ave
Orange, CA 92866-1643
Phone
(714) 639-4012
NPI assigned
Jun 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A24205 CA Primary

Addresses

Primary practice location

615 E Chapman Ave
Orange, CA 92866-1643

Mailing address

615 E Chapman Ave
Orange, CA 92866-1643
Phone (714) 639-4012

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26582 Kari BRK
Lake Forest, CA 92630-5617

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1487348652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643",
            "telephone_number": "714-639-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643",
            "telephone_number": "714-639-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURESFANDIARI",
        "first_name": "POUYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A24205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.