Individual provider Active NPI

Farzin Mohtadi, D.O.

  • Family Medicine Physician
  • Mission Viejo, CA
National Provider Identifier
1528077682
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A9219 Issued in CA
Practice address
26712 Sierra Vista
Mission Viejo, CA 92692
Phone
(949) 306-1663
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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 20A9219 CA Primary

Addresses

Primary practice location

26712 Sierra Vista
Mission Viejo, CA 92692

Mailing address

26712 Sierra Vista
Mission Viejo, CA 92692
Phone (949) 306-1663

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A9219CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cypress Urgent Care, Inc PastSince Oct 1, 2009 Accepting new patients
Portola Medical Services PC Family Medicine Past Accepting new patients
Medical Body Concepts, PC. Family Medicine Past Accepting new patients
Hoag Urgent Care - Huntington Harbour Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1528077682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26712 SIERRA VISTA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-306-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26712 SIERRA VISTA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-306-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHTADI",
        "first_name": "FARZIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.