Lida Ghaderi, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A063230 Issued in CA

Practice address

2222 Santa Monica Blvd
Suite 200
Santa Monica, CA 90404-2304

Phone

(310) 998-8600

NPI assigned

Feb 16, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1851613079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SANTA MONICA BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042304",
            "telephone_number": "310-998-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 SANTA MONICA BLVD",
            "address_2": "SUITE 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042304",
            "telephone_number": "310-998-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHADERI",
        "first_name": "LIDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A063230",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "CA",
            "license": "A063230",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A063230",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "A063230",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A063230",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A063230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana Joy Gerson
• Paul S Gerstenfeld, MS, OTR/L, CHT
• Angelique Gettle, L.M.F.T.
• Brandon Gettleman
• Todd Michael Gewant, D.C.
• Shirin Ghafouri, PHARMD
• Joshua Jonah Ghaly
• Javid Ghandehari, M.D.
• Marjan Ghanem, PHARMD
• Stephen Ghazikhanian

• Internal Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.