Active NPI
Davood Betaharon, MD
- Family Medicine Physician
- Encino, CA
National Provider Identifier
1740449883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A042747
- Practice address
- 18065 Ventura Blvd
Encino, CA 91316 - Phone
- (818) 708-6163
- Fax
- (818) 708-6167
- NPI assigned
- Jun 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A042747 | CA | Primary |
Addresses
Primary practice location
18065 Ventura Blvd
Encino, CA 91316
Mailing address
18375 Collins St
#130
Tarzana, CA 91356
Phone (818) 343-7850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A042747 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213833600000",
"number": "1740449883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18375 COLLINS ST",
"address_2": "#130",
"city": "TARZANA",
"state": "CA",
"postal_code": "91356",
"telephone_number": "818-343-7850",
"fax_number": "818-708-6167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18065 VENTURA BLVD",
"city": "ENCINO",
"state": "CA",
"postal_code": "91316",
"telephone_number": "818-708-6163",
"fax_number": "818-708-6167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETAHARON",
"first_name": "DAVOOD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-04",
"last_updated": "2008-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A042747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.