Shahram Javaheri, MD, Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A064239 Issued in CA

Legal business name

SHAHRAM JAVAHERI, MD, INC.

Practice address

26691 Plaza Ste 150
Mission Viejo, CA 92691-6329

Phone

(949) 389-0660

Fax

(949) 389-0668

NPI assigned

Sep 20, 2006

Last updated

Dec 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shahram Javaheri, M.D.NPI 1497861439

Title

Ceo

Phone

(949) 389-0660

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Shahram Javaheri, M.D.

  • Gastroenterology Physician
  • Mission Viejo, CA
  • NPI 1497861439
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1760589097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12512",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585065",
            "telephone_number": "949-389-0660",
            "fax_number": "949-389-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-389-0660",
            "fax_number": "949-389-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRAM JAVAHERI, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "JAVAHERI",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-389-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A064239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A642390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.