Kenneth Kambiz Gheysar, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

G 71924 Issued in CA

Practice address

23046 Avenida de la Carlota Ste 600
Laguna Hills, CA 92653-1537

Phone

(949) 306-2566

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Tavarua Health Services

  • Methadone Clinic
  • Pico Rivera, CA
  • NPI 1235344086
  NPD
• Tavarua Rehabilitation Services

  • Methadone Clinic
  • Azusa, CA
  • NPI 1841679131
  NPD
• West County Medical Clinic

  • Methadone Clinic
  • Long Beach, CA
  • NPI 1851501233
  NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1609992171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23046 AVENIDA DE LA CARLOTA STE 600",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531537",
            "telephone_number": "949-306-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23046 AVENIDA DE LA CARLOTA STE 600",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531537",
            "telephone_number": "949-306-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEYSAR",
        "first_name": "KENNETH",
        "middle_name": "KAMBIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "G 71924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Gharabati, AMFT
• Roxana Ghashghaei, M.D.
• Ghazvini & Javaheri, M.D., Inc
• Ghazvini MD,Inc
• Ali Ghazvini, M.D.
• Kia Ghiassi, D.O.
• Ruxanda Ghibu, D,M.D.
• Julie Gibson
• Patricia Jane Gifford, MD
• Sara Gilles, PT

• Addiction Medicine (Family Medicine) Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Addiction Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.