NPIMap

Individual provider Active NPI

Keivan Golchini, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1528074812
Registry record updated Sep 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A48800 Issued in CA
Practice address
11835 W Olympic Blvd
Ste 855E
Los Angeles, CA 90064-5060
Phone
(310) 276-7649
Fax
(714) 602-6784
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A48800 CA Primary

Addresses

Primary practice location

11835 W Olympic Blvd
Ste 855E
Los Angeles, CA 90064-5060

Mailing address

9100 Wilshire Blvd
# 245 East
Beverly Hills, CA 90212
Phone (310) 276-7649

Other identifiers 1

IdentifierTypeStateIssuer
00A488001MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000480 CA Practitioner - Gastroenterology 9335034107 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA; Perris, CA

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4316 Slauson Ave
Maywood, CA 90270-2838
Phone (323) 773-2020

Hospital & facility affiliations

  • Media Home Health Home health agency, Glendale, CA, CCN 058458
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
  • L a Downtown Medical Center Hospital, Los Angeles, CA, CCN 050763
  • Kindred Hospital South Bay Long-term care hospital, Gardena, CA, CCN 052050
  • Kindred Hospital Paramount Long-term care hospital, Paramount, CA, CCN 052046
  • Kindred Hospital Riverside Long-term care hospital, Perris, CA, CCN 052052
  • Brighton Care Center Nursing home, Pasadena, CA, CCN 555338
  • Saint Vincent Healthcare Nursing home, Pasadena, CA, CCN 555119
  • Alden Terrace Convalescent Hospital Nursing home, Los Angeles, CA, CCN 056237

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48800CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shane Medical Office a Professional Corporation Internal Medicine CurrentSince Jun 1, 2002 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Keivan Golchini, MD Inc. Past Accepting new patients

Locations

4316 Slauson Ave
Maywood, CA 90270
Phone (323) 771-9867

Organizations & group practices 3

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1528074812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WILSHIRE BLVD",
            "address_2": "# 245 EAST",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90212",
            "telephone_number": "310-276-7649",
            "fax_number": "714-602-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD",
            "address_2": "STE 855E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645060",
            "telephone_number": "310-276-7649",
            "fax_number": "714-602-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLCHINI",
        "first_name": "KEIVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A48800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A488001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.