Individual provider Active NPI

Maurice Mehrban, MD., ESQ.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1902027626
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A038224 Issued in CA
Practice address
10481 Santa Monica Blvd
Los Angeles, CA 90025-5031
Phone
(310) 592-5906
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A038224 CA Primary

Addresses

Primary practice location

10481 Santa Monica Blvd
Los Angeles, CA 90025-5031

Mailing address

10481 Santa Monica Blvd
Los Angeles, CA 90025-5031

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
I20101004000238 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 4880886332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10481 Santa Monica Blvd
Los Angeles, CA 90025-5031
Phone (310) 592-5906

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A038224CAMDSpecialist

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902027626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10481 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10481 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255031",
            "telephone_number": "310-592-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRBAN",
        "first_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "MD., ESQ.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A038224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.