Organization Active NPI

Shahryar Davari MD PC

  • Internal Medicine Physician
  • Downey, CA
National Provider Identifier
1770083081
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76725 Issued in CA
Legal business name
SHAHRYAR DAVARI MD PC
Practice address
11544 Downey Ave
Downey, CA 90241-4955
Phone
(562) 922-2020
Fax
(562) 286-8226
NPI assigned
Feb 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Authorized official

Name
Shahryar Davari, M.D.NPI 1346244373
Title
M.D./President
Phone
(562) 922-2020

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A76725 CA Primary

Addresses

Primary practice location

11544 Downey Ave
Downey, CA 90241-4955

Mailing address

17595 Harvard Ave # C1005
Irvine, CA 92614-8516

Other identifiers 1

IdentifierTypeStateIssuer
A76725OtherCAMEDICAL BOARD OF CALIFORNIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180511000965 CA Part B Supplier - Clinic/Group Practice 3476817867 Receives reassigned benefits from 1 practitioner
Practice locations: Paramount, CA; Los Alamitos, CA; Lakewood, CA; Downey, CA; Bellflower, CA

National Provider Directory

National Provider Directory

Locations

11544 Downey Ave
Downey, CA 90241
Phone (562) 414-9846

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": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1770083081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17595 HARVARD AVE # C1005",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11544 DOWNEY AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902414955",
            "telephone_number": "562-922-2020",
            "fax_number": "562-286-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRYAR DAVARI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "DAVARI",
        "authorized_official_first_name": "SHAHRYAR",
        "authorized_official_title_or_position": "M.D./PRESIDENT",
        "authorized_official_telephone_number": "562-922-2020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A76725",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

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