NPIMap

Organization Active NPI

Delta Pediatrics Medical Group, Inc.

Doing business as Abbas Mahdavi, M.D., Inc.

  • Preferred Provider Organization
  • Antioch, CA
National Provider Identifier
1750334660
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
A313250 Issued in CA
Legal business name
DELTA PEDIATRICS MEDICAL GROUP, INC.
Doing business as
Abbas Mahdavi, M.D., Inc.
Practice address
3903 Lone Tree Way
Ste. 211
Antioch, CA 94509-6249
Phone
(925) 754-7200
Fax
(925) 754-7290
NPI assigned
May 19, 2006
Last updated
Aug 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Mr. Abbas Mahdavi, M.D.NPI 1194134049
Title
Owner/President
Phone
(925) 754-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X A313250 CA Primary

Addresses

Primary practice location

3903 Lone Tree Way
Ste. 211
Antioch, CA 94509-6249

Mailing address

3903 Lone Tree Way
Ste. 211
Antioch, CA 94509-6249
Phone (925) 754-7200

Other names 1

  • Abbas Mahdavi, M.D., Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abbas Mahdavi MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1750334660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY",
            "address_2": "STE. 211",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096249",
            "telephone_number": "925-754-7200",
            "fax_number": "925-754-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY",
            "address_2": "STE. 211",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096249",
            "telephone_number": "925-754-7200",
            "fax_number": "925-754-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA PEDIATRICS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "MAHDAVI",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "925-754-7200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "A313250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abbas Mahdavi, M.D., Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, CA

Sources for this page

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

Verify at the official NPI Registry.