Shahab Mehdizadeh MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A76490 Issued in CA

Legal business name

SHAHAB MEHDIZADEH MD INC

Practice address

240 S la Cienega Blvd
102
Beverly Hills, CA 90211-3324

Phone

(310) 246-4100

Fax

(310) 285-2029

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shahab Mehdizadeh, MDNPI 1790715241

Title

President

Phone

(310) 246-4100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Shahab Mehdizadeh, M.D.

  • Gastroenterology Physician
  • Beverly Hills, CA
  • NPI 1790715241
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1568669596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S LA CIENEGA BLVD",
            "address_2": "102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113324",
            "telephone_number": "310-246-4100",
            "fax_number": "310-285-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S LA CIENEGA BLVD",
            "address_2": "102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113324",
            "telephone_number": "310-246-4100",
            "fax_number": "310-285-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHAB MEHDIZADEH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "MEHDIZADEH",
        "authorized_official_first_name": "SHAHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-246-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A76490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A76490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliza S. Azad Shafa, RDH
• Shervin Shaffiy, M.D.
• Nilomi Nilesh Shah, PHARMD
• Rina Bihari Shah, MD
• Roshni Shah, M.D
• Ladan Shahabi, MD
• Cigal Tzivia Shaham, M.D., M.SC.
• Monica Shahbaznia Alvarez, PH.D.
• Shirin Shahedi, D.M.D.
• Noosha Shaheedy, M.D.

• Gastroenterology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.