Organization Active NPI

Shaun S Daneshrad MD a Medical Corporation

  • Specialist
  • Beverly Hills, CA
National Provider Identifier
1689619454
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G70241 Issued in CA
Legal business name
SHAUN S DANESHRAD MD A MEDICAL CORPORATION
Practice address
8920 Wilshire Blvd
Suite 420
Beverly Hills, CA 90211-2007
Phone
(310) 652-5210
Fax
(310) 652-5211
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Shaun S Daneshrad, M.D.NPI 1962452565
Title
President
Phone
(310) 652-5210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G70241 CA Primary

Addresses

Primary practice location

8920 Wilshire Blvd
Suite 420
Beverly Hills, CA 90211-2007

Mailing address

PO Box 2054
Beverly Hills, CA 90213-2054
Phone (310) 652-5210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060807000475 CA Part B Supplier - Clinic/Group Practice 0941203210 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA; Beverly Hills, CA

National Provider Directory

National Provider Directory

Locations

5901 W Olympic Blvd
Ste 107
Los Angeles, CA 90036
Phone (323) 938-0071

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1689619454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2054",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902132054",
            "telephone_number": "310-652-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "SUITE 420",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112007",
            "telephone_number": "310-652-5210",
            "fax_number": "310-652-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAUN S DANESHRAD MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "DANESHRAD",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-652-5210",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G70241",
            "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 Apr 5, 2011; 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.