Khashayar Mohebali MD a Medical Corporation

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A94434 Issued in CA

Legal business name

KHASHAYAR MOHEBALI MD A MEDICAL CORPORATION

Practice address

21 Tamal Vista Blvd
Suite 103
Corte Madera, CA 94925-1130

Phone

(415) 927-7660

Fax

(415) 927-7663

NPI assigned

May 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Khashayar Mohebali, MDNPI 1437331360

Title

President

Phone

(415) 412-4921

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khashayar Mohebali, MD

  • Plastic Surgery Physician
  • San Francisco, CA
  • NPI 1437331360
  Medicare reassignment Care Compare group NPD Authorized official
• Anya Peysakhovich, PA-C

  • Surgical Physician Assistant
  • Corte Madera, CA
  • NPI 1215423363
  Medicare reassignment Care Compare group
• Debra Beth Anziano, PA-C

  • Surgical Physician Assistant
  • Corte Madera, CA
  • NPI 1538183686
  Medicare reassignment

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1881030484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 COLUMBIA CREEK DR",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825611",
            "telephone_number": "925-556-4336",
            "fax_number": "925-556-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD",
            "address_2": "SUITE 103",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251130",
            "telephone_number": "415-927-7660",
            "fax_number": "415-927-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHASHAYAR MOHEBALI MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "MOHEBALI",
        "authorized_official_first_name": "KHASHAYAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-412-4921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A94434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Kaufmann, R.N., DC. C.T.N.
• Caroline Mirei Kawashima, MS
• Lauren Kazanjian
• Judith Anne Keins, M.D.
• Nicolas Daniel James Kenig
• Rosemary Kim, L.AC
• Margot Kirschner, PSY.D.
• David Bryan Kitts, L.AC.
• Elizabeth Klinger, LPCC
• Lawrence Knapp, M.D.

• Plastic Surgery Physician in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.