NPIMap

Organization Active NPI

Ashkan Etemadian MD Inc

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1508158783
Registry record updated May 6, 2011
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Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A105385 Issued in CA
Legal business name
ASHKAN ETEMADIAN MD INC
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(949) 764-4624
NPI assigned
May 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Ashkan Etemadian, MD
Title
President
Phone
(949) 701-2973

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A105385 CA Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

32565 B Golden Lantern
#167
Dana Point, CA 92629
Phone (949) 701-2973

Other identifiers 1

IdentifierTypeStateIssuer
A105385OtherCASTATE LICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1508158783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32565 B GOLDEN LANTERN",
            "address_2": "#167",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "92629",
            "telephone_number": "949-701-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHKAN ETEMADIAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "ETEMADIAN",
        "authorized_official_first_name": "ASHKAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-701-2973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A105385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "A105385",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.