Individual provider Active NPI

Behrooz Bruce Yagoobian, M.D.

  • Family Medicine Physician
  • Paramount, CA
National Provider Identifier
1780613570
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A48328 Issued in CA
Practice address
15730 Paramount Blvd
Paramount, CA 90723-4333
Phone
(562) 634-1000
Fax
(562) 634-3048
NPI assigned
Jul 2, 2006
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A48328 CA Primary
Pediatrics Physician 208000000X A48328 CA

Addresses

Primary practice location

15730 Paramount Blvd
Paramount, CA 90723-4333

Mailing address

PO Box 829
Paramount, CA 90723-0829
Phone (562) 634-1000

Other identifiers 2

IdentifierTypeStateIssuer
0108328OtherCAPIN
GR0067270MedicaidCA

Other names 1

  • Mr. Behrooz Yagoobian Former name

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
I20040608000827 CA Practitioner - Geriatric MedicinePractitioner - General PracticePractitioner - Pediatric Medicine 3375532104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Pediatric Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15730 Paramount Blvd
Paramount, CA 90723-4333
Phone (562) 634-1000

6907 Seville Ave
Huntington PK, CA 90255-4901
Phone (323) 588-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48328CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alianza Medical Center Inc Family Medicine CurrentSince Jan 1, 2003 Accepting new patients
Cedars-Sinai Medical Center PastSince Jan 1, 2003 Accepting new patients
Clinica Medica Americana Medical Center General Practice PastSince May 18, 2004 Accepting new patients

Locations

6907 Seville Ave
Huntington Pk, CA 90255
Phone (323) 588-1100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1780613570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 829",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907230829",
            "telephone_number": "562-634-1000",
            "fax_number": "562-634-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15730 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907234333",
            "telephone_number": "562-634-1000",
            "fax_number": "562-634-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGOOBIAN",
        "first_name": "BEHROOZ",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48328",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A48328",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "0108328",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEHROOZ",
            "last_name": "YAGOOBIAN",
            "prefix": "MR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paramount, CA

Sources for this page

Verify at the official NPI Registry.