Organization Active NPI

Sherman Oaks Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Sherman Oaks, CA
National Provider Identifier
1831569094
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SHERMAN OAKS AMBULATORY SURGERY CENTER
Practice address
4940 Van Nuys Blvd Ste 103
Sherman Oaks, CA 91403-1739
Phone
(818) 990-9074
Fax
(818) 990-9076
NPI assigned
Sep 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Mehras Akhavan, M.D.NPI 1497817332
Title
President
Phone
(818) 990-9074

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
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4940 Van Nuys Blvd Ste 103
Sherman Oaks, CA 91403-1739

Mailing address

4940 Van Nuys Blvd Ste 103
Sherman Oaks, CA 91403-1739
Phone (818) 990-9074

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160105001710 CA Part B Supplier - Ambulatory Surgical Center 0143522334 Receives reassigned benefits from 1 practitioner
Practice locations: Sherman Oaks, CA

Ambulatory surgical center certification: CCN 55C0001218

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SHERMAN OAKS AMBULATORY SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Aug 12, 2025
Last certification
Jul 8, 2025
Facility address
4940 Van Nuys Blvd
Sherman Oaks, CA 91403

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2113090Sherman Oaks Ambulatory4940 Van Nuys Blvd Ste 103, Sherman Oaks, CA 91403Certificate of waiverMay 15, 2028

National Provider Directory

National Provider Directory

Locations

4940 Van Nuys Blvd
Ste 103
Sherman Oaks, CA 91403
Phone (818) 990-9074

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": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1831569094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD STE 103",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031739",
            "telephone_number": "818-990-9074",
            "fax_number": "818-990-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD STE 103",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031739",
            "telephone_number": "818-990-9074",
            "fax_number": "818-990-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERMAN OAKS AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "AKHAVAN",
        "authorized_official_first_name": "MEHRAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-990-9074",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.