NPIMap

Organization Active NPI

Shahram F. Ravan, M.D. Inc.

  • Specialist
  • Beverly Hills, CA
National Provider Identifier
1689869190
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A40168 Issued in CA
Legal business name
SHAHRAM F. RAVAN, M.D. INC.
Practice address
436 N Bedford Dr
Suite 214
Beverly Hills, CA 90210-4310
Phone
(310) 858-9200
Fax
(310) 271-3793
NPI assigned
Sep 7, 2007
Organization subpart
Yes
Parent organization
SHAHRAM F. RAVAN, M.D.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Dr. Shahram Francois Ravan, MDNPI 1073544417
Title
MD/President
Phone
(310) 858-9200

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: 193200000X MULTI-SPECIALTY GROUP 174400000X A40168 CA Primary

Addresses

Primary practice location

436 N Bedford Dr
Suite 214
Beverly Hills, CA 90210-4310

Mailing address

436 N Bedford Dr
Suite 214
Beverly Hills, CA 90210-4310
Phone (310) 858-9200

Other identifiers 1

IdentifierTypeStateIssuer
00A401680MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Shahram F Ravan MD Inc3 organizations share this tax ID, including this one
Part of
Shahram F Ravan MD Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7842/brand/1/csg/1/fhir/r4

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1689869190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR",
            "address_2": "SUITE 214",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104310",
            "telephone_number": "310-858-9200",
            "fax_number": "310-271-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR",
            "address_2": "SUITE 214",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104310",
            "telephone_number": "310-858-9200",
            "fax_number": "310-271-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRAM F. RAVAN, M.D. INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAHRAM F. RAVAN, M.D.",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "RAVAN",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_middle_name": "FRANCOIS",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "310-858-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A40168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A401680",
            "state": "CA"
        }
    ],
    "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 Sep 7, 2007; 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.