Organization Active NPI

Sean William Kaloostian MD Inc.

  • Neurological Surgery Physician
  • Riverside, CA
National Provider Identifier
1760137335
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
SEAN WILLIAM KALOOSTIAN MD INC.
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4199
Phone
(951) 788-3000
NPI assigned
Feb 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Authorized official

Name
Dr. Sean William Kaloostian, MDNPI 1750607099
Title
President
Phone
(818) 836-0978

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4199

Mailing address

333 S San Rafael Ave
Pasadena, CA 91105-1542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220323000173 CA Part B Supplier - Clinic/Group Practice 3971998204 Receives reassigned benefits from 1 practitioner
Practice locations: Corona, CA; Riverside, CA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1760137335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S SAN RAFAEL AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911051542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAN WILLIAM KALOOSTIAN MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "KALOOSTIAN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-836-0978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.