Ava Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A80009 Issued in CA

Legal business name

AVA MEDICAL CORPORATION

Practice address

1329 W Warner Ave
Santa Ana, CA 92704-5118

Phone

(714) 444-0044

Fax

(714) 444-0043

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Homa Shoghian-Shabanpour, M.D.NPI 1487797502

Title

Director

Phone

(714) 444-0044

Specialties & licenses 1

Addresses

Other identifiers 1

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 1

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

• Homa Shoghian-Shabanpour, M.D

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1487797502
  NPD (past) Authorized official

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1689846503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045118",
            "telephone_number": "714-444-0044",
            "fax_number": "714-444-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045118",
            "telephone_number": "714-444-0044",
            "fax_number": "714-444-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "SHOGHIAN-SHABANPOUR",
        "authorized_official_first_name": "HOMA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-444-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A80009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A80009",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.