NPIMap

Organization Active NPI

Cardiology Vascular & Endocrinology Center Professional Corporation

  • Cardiovascular Disease Physician
  • Thousand Oaks, CA
National Provider Identifier
1578311015
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOLOGY VASCULAR & ENDOCRINOLOGY CENTER PROFESSIONAL CORPORATION
Practice address
2220 Lynn Rd
Thousand Oaks, CA 91360-1904
Phone
(661) 395-3055
NPI assigned
May 9, 2024
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Dr. Khazai Bahram, M.D.
Title
Owner/President
Phone
(615) 557-6692

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU

Addresses

Primary practice location

2220 Lynn Rd
Thousand Oaks, CA 91360-1904

Mailing address

2220 Lynn Rd
Thousand Oaks, CA 91360-1904
Phone (661) 395-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240802000755 CA Part B Supplier - Clinic/Group Practice 9234676693 Receives reassigned benefits from 1 practitioner
Practice locations: Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

2220 Lynn Rd
Thousand Oaks, CA 91360
Phone (661) 395-3055

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1578311015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601904",
            "telephone_number": "661-395-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601904",
            "telephone_number": "661-395-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY VASCULAR & ENDOCRINOLOGY CENTER PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "BAHRAM",
        "authorized_official_first_name": "KHAZAI",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "615-557-6692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.