Individual provider Active NPI

Mahmoud Yeganeh Hajahmadi

  • Acupuncturist
  • Fountain Valley, CA
National Provider Identifier
1780010066
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
15561 Issued in CA
Practice address
10231 Slater Ave
Suite # 113
Fountain Valley, CA 92708-4773
Phone
(714) 968-4446
NPI assigned
Sep 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 15561 CA Primary

Addresses

Primary practice location

10231 Slater Ave
Suite # 113
Fountain Valley, CA 92708-4773

Mailing address

10231 Slater Ave Ste 113
Fountain Valley, CA 92708-4745
Phone (213) 375-8850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15561CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neck & Back Pain Specialists, a Balta Chiropractic Corporation PastSince Sep 6, 2020 Accepting new patients

Organizations & group practices 1

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1780010066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10231 SLATER AVE STE 113",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084745",
            "telephone_number": "213-375-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10231 SLATER AVE",
            "address_2": "SUITE # 113",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084773",
            "telephone_number": "714-968-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEGANEH HAJAHMADI",
        "first_name": "MAHMOUD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-19",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "15561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.