Organization Active NPI

Keven Tagdiri M.D., Inc.

  • Internal Medicine Physician
  • Encinitas, CA
National Provider Identifier
1760722433
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KEVEN TAGDIRI M.D., INC.
Practice address
4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938
Phone
(858) 756-3021
NPI assigned
Feb 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Dr. Keven Tagdiri, M.D.
Title
Owner
Phone
(858) 756-3021

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 871851
Registered Dietetic TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 136A00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938

Mailing address

4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938
Phone (858) 756-3021

National Provider Directory

National Provider Directory
Tax ID family
Keven Tagdiri MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1760722433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "858-756-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "858-756-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVEN TAGDIRI M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "TAGDIRI",
        "authorized_official_first_name": "KEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-756-3021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "871851",
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.