Individual provider Active NPI

Arvin Doostan, MD

  • Dermatology Physician
  • Lancaster, CA
National Provider Identifier
1770740862
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A116161 Issued in CA
Practice address
43112 15TH St W
Lancaster, CA 93534-6219
Phone
(166) 166-1729
NPI assigned
May 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A116161 CA Primary

Addresses

Primary practice location

43112 15TH St W
Lancaster, CA 93534-6219

Mailing address

43112 15TH St W
Lancaster, CA 93534-6219

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000402 CA Practitioner - Dermatology 0042482416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116161CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 29, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 29, 2011 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1770740862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43112 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346219",
            "telephone_number": "166-166-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOSTAN",
        "first_name": "ARVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-17",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A116161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.