Individual provider Active NPI

Cyrus Heravi

  • Registered Nurse
  • Long Beach, CA
National Provider Identifier
1902634710
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95154209 Issued in CA
Practice address
1024 Prospect Ave
Long Beach, CA 90804-4379
Phone
(949) 683-3704
NPI assigned
Jul 23, 2024
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95154209 CA Primary

Addresses

Primary practice location

1024 Prospect Ave
Long Beach, CA 90804-4379

Mailing address

1024 Prospect Ave
Long Beach, CA 90804-4379
Phone (949) 683-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95154209CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1902634710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 PROSPECT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044379",
            "telephone_number": "949-683-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 PROSPECT AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044379",
            "telephone_number": "949-683-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERAVI",
        "first_name": "CYRUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95154209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.