Khoddami Medical Group Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

KHODDAMI MEDICAL GROUP INC

Practice address

2705 Loma Vista Rd Ste 206
Ventura, CA 93003-1584

Phone

(805) 652-5469

NPI assigned

Jul 19, 2019

Last updated

Jul 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Seyed Khoddami, MDNPI 1437278603

Title

President

Phone

(805) 652-5469

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, and the practitioner matching its NPPES authorized official.

• Seyed Mohammad Reza Khoddami, M.D.

  • Urology Physician
  • Ventura, CA
  • NPI 1437278603
  NPD Authorized official

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1598318461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-641-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 LOMA VISTA RD STE 206",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031584",
            "telephone_number": "805-652-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHODDAMI MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "KHODDAMI",
        "authorized_official_first_name": "SEYED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-652-5469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Shakeel Akram Khawaja, DDS
• Khazali Dental Corporation (Main Street Dental Group)
• Khepera House Inc
• Khepera House Inc
• Khepera House Inc
• Seyed Mohammad Reza Khoddami, M.D.
• Mary Georgiana Kiddle, RDN
• Kidney Dialysis Center of Ventura,LLC
• Kelly Marie Kidon, DDS
• Kids & Families Together

• Urology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.