Aram Adam Khadivi, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

1750058046 Issued in CA

Practice address

1223 26TH St
San Diego, CA 92102-1005

Phone

(818) 292-1106

NPI assigned

Aug 25, 2021

Last updated

Feb 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1750058046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "818-292-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 26TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921021005",
            "telephone_number": "818-292-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADIVI",
        "first_name": "ARAM",
        "middle_name": "ADAM",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": "1750058046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Khachatryan
• Tatevik Khachatryan
• Mojgan Khademi, PSY.D.
• Waseem Majed Khader, D.O.
• Natasha Khadir
• Bahram Khadivi, M.D.
• Sara Minor Khadivi
• Anastasia Khadjinova, MD
• Mohamad Hadi Khafaja, MD
• Saneel Shreekant Khairnar

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.