Mariam Moghadam, M.D., Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A86456 Issued in CA

Legal business name

MARIAM MOGHADAM, M.D., INC.

Practice address

81 Highland Springs Ave.
Suite #306
Beaumont, CA 92223-3170

Phone

(951) 769-2222

Fax

(951) 769-2204

NPI assigned

Jun 12, 2012

Organization subpart

No

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

Authorized official

Name

Mariam Susan Moghadam, M.D.

Title

President

Phone

(951) 769-2222

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Stephan Anders, D.O.

  • Family Medicine Physician
  • Beaumont, CA
  • NPI 1124369087
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1518229806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8307",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751507",
            "telephone_number": "951-769-2222",
            "fax_number": "951-769-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND SPRINGS AVE.",
            "address_2": "SUITE #306",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233170",
            "telephone_number": "951-769-2222",
            "fax_number": "951-769-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAM MOGHADAM, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MOGHADAM",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-769-2222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward John Lopez
• Los Feliz Hospice Health Care
• Khanh Luong, AS PT (PTA)
• Tammi Magie, COTA
• Nancy Mwende Malika
• Tiffany Markham, RN
• Mary Ellen Marquez-Hood
• Kathleen Sarah Martin, MD
• Donna Martinez, CMT
• Jesus Edwardo Martinez, DDS

• Family Medicine Physician in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.