Kourosh Bagheri, M.D., M.S., a Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G77496 Issued in CA

Legal business name

KOUROSH BAGHERI, M.D., M.S., A PROFESSIONAL CORPORATION

Practice address

75 Parnassus Rd
Berkeley, CA 94708-2056

Phone

(805) 781-9111

Fax

(805) 285-4055

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Kourosh Darren Bagheri, MD

Title

MD/Owner

Phone

(805) 781-9111

Specialties & licenses 2

Addresses

Other names 1

• Bagheri Medical Group Doing business as

Locations

Practitioners 4

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

• Sabina Miller

  • Speech-Language Pathologist
  • Alhambra, CA
  • NPI 1548665631
  NPD
• Lauren M Stowe, PHD, CCC-SLP

  • Speech-Language Pathologist
  • San Luis Obispo, CA
  • NPI 1790013639
  NPD
• Ardeshir Ali Talieh, MD

  • Internal Medicine Physician
  • San Luis Obispo, CA
  • NPI 1467454819

  Internal Medicine

  NPD (past)
• Michelle Alena Taylor, R.N., M.S.N., A.C.N.

  • Nurse Practitioner
  • San Luis Obispo, CA
  • NPI 1013124536
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1740367275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PARNASSUS RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947082056",
            "telephone_number": "805-781-9111",
            "fax_number": "805-285-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PARNASSUS RD",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947082056",
            "telephone_number": "805-781-9111",
            "fax_number": "805-285-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOUROSH BAGHERI, M.D., M.S., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "BAGHERI",
        "authorized_official_first_name": "KOUROSH",
        "authorized_official_middle_name": "DARREN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "805-781-9111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G77496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bagheri Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bagheri Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Kot
• Sharadamba Kota, PHYSICAL THERAPIST
• Ernest Marvin Kotlier, M.D.
• Jasmin Kouhkan
• Iramis Kouromenos
• Steven Corey Kowaleski, MD
• Adela Kozarova Huson
• Tomie Sasaki Kratz, L.C.S.W.
• Rebecca Kraus, LCSW
• Ronald M Krauss, MD

• All providers in Berkeley, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.