Shalom Pain Treatment Medical Center Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A50982 Issued in CA

Legal business name

SHALOM PAIN TREATMENT MEDICAL CENTER INC

Practice address

1016 S Robertson Blvd
Los Angeles, CA 90035-1505

Phone

(818) 497-3797

Fax

(310) 860-1326

NPI assigned

Mar 29, 2006

Last updated

May 24, 2016By 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

Kourosh Noormand, M.D.NPI 1750357182

Title

Direct Owner

Phone

(818) 497-3797

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shalom Pain Tretament Medical Ctr, Inc.

  • Specialist
  • Beverly Hills, CA
  • NPI 1023069804

  O20050502000231

  Same enrollment

Practitioners 6

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.

• Kourosh Noormand, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Los Angeles, CA
  • NPI 1750357182
  Medicare reassignment Authorized official
• Elina Adibi, DC

  • Chiropractor
  • Los Angeles, CA
  • NPI 1780924779
  NPD (past)
• Elham Azarmiazam, D.C.

  • Chiropractor
  • Los Angeles, CA
  • NPI 1407202393
  NPD (past)
• Alfred A Derakhshesh, D.C.

  • Chiropractor
  • Los Angeles, CA
  • NPI 1336183110
  NPD (past)
• Daniel Drake, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1285847681
  NPD (past)
• Daniel Radnia, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Los Angeles, CA
  • NPI 1659394633
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1598726531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16713",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902092713",
            "telephone_number": "818-497-3797",
            "fax_number": "310-860-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351505",
            "telephone_number": "818-497-3797",
            "fax_number": "310-860-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM PAIN TREATMENT MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "NOORMAND",
        "authorized_official_first_name": "KOUROSH",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "818-497-3797",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A50982",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A50982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Shallbetter, PH.D,PSY.D
• Gabriel Thomas Shallcross II
• Elizabeth Shallenberger, NP
• Michele Marian Shalloe, RN
• Antonio Shallowhorn
• Shalom RX Inc (Western Top Pharmacy)
• Yosef Shaltiel
• Anne Shaltz
• Isabel Shalumova
• Shalva, a Psychology Corporation

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.