Organization Active NPI

Pedram Navab DO Inc

  • Clinical Neurophysiology Physician
  • Palm Springs, CA
National Provider Identifier
1720465578
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
Legal business name
PEDRAM NAVAB DO INC
Practice address
1180 N Indian Canyon Drive
Suite W201
Palm Springs, CA 92262-4402
Phone
(760) 416-4511
Fax
(760) 416-4515
NPI assigned
Apr 30, 2015
Last updated
May 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Dr. Pedram Navab, D.O.NPI 1194750984
Title
Osteopathic Doctor
Phone
(760) 416-4511

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0012X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X Primary

Addresses

Primary practice location

1180 N Indian Canyon Drive
Suite W201
Palm Springs, CA 92262-4402

Mailing address

1180 N Indian Canyon Dr
Suite W201
Palm Springs, CA 92262-4800
Phone (760) 416-4511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161103001393 CA Part B Supplier - Clinic/Group Practice 1759669211 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

81767 Doctor Carreon Blvd
Ste 203
Indio, CA 92201

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1720465578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "SUITE W201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "760-416-4511",
            "fax_number": "760-416-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DRIVE",
            "address_2": "SUITE W201",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624402",
            "telephone_number": "760-416-4511",
            "fax_number": "760-416-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDRAM NAVAB DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "NAVAB",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_title_or_position": "OSTEOPATHIC DOCTOR",
        "authorized_official_telephone_number": "760-416-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.