Individual provider Active NPI

Jamie Mahtaban, D.C.

  • Chiropractor
  • Beverly Hills, CA
National Provider Identifier
1649512674
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32573 Issued in CA
Practice address
8920 Wilshire Blvd
#520
Beverly Hills, CA 90211-2007
Phone
(310) 432-2880
NPI assigned
Mar 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32573 CA Primary

Addresses

Primary practice location

8920 Wilshire Blvd
#520
Beverly Hills, CA 90211-2007

Mailing address

8920 Wilshire Blvd Ste 610
Beverly Hills, CA 90211-2006
Phone (310) 666-2776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130613000393 CA Practitioner - Chiropractic 3971742495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8920 Wilshire Blvd
Suite 610
Beverly Hills, CA 90211-2006
Phone (310) 880-1695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic & Wellness Center Chiropractor CurrentSince May 7, 2013 Accepting new patients

Locations

239 S La Cienega Blvd
Ste 201
Beverly Hills, CA 90211
Phone (310) 289-1200

8920 Wilshire Blvd
Ste 610
Beverly Hills, CA 90211
Phone (310) 666-2776

8920 Wilshire Blvd
Ste 520
Beverly Hills, CA 90211
Phone (310) 432-2880

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1649512674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD STE 610",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112006",
            "telephone_number": "310-666-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "#520",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112007",
            "telephone_number": "310-432-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHTABAN",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-15",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.