Organization Active NPI

Pouya Lavian MD Inc a Medical Corporation

  • Neuromusculoskeletal Medicine & OMM Physician
  • Encino, CA
National Provider Identifier
1922429406
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
A109429 Issued in CA
Legal business name
POUYA LAVIAN MD INC A MEDICAL CORPORATION
Practice address
16661 Ventura Blvd Ste 820
Encino, CA 91436-4801
Phone
(818) 394-0884
Fax
(818) 217-8318
NPI assigned
Dec 30, 2013
Last updated
Feb 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Authorized official

Name
Dr. Pouya Lavian, MDNPI 1912196874
Title
President
Phone
(818) 394-0884

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
Neuromusculoskeletal Medicine & OMM Physician 204D00000X A109429 CA Primary

Addresses

Primary practice location

16661 Ventura Blvd Ste 820
Encino, CA 91436-4801

Mailing address

16661 Ventura Blvd Ste 820
Encino, CA 91436-4801
Phone (818) 394-0884

Other identifiers 1

IdentifierTypeStateIssuer
A109429OtherCALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140401002060 CA Part B Supplier - Clinic/Group Practice 8022249200 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

5363 Balboa Blvd
Ste 242
Encino, CA 91316
Phone (818) 382-3630

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1922429406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 820",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364801",
            "telephone_number": "818-394-0884",
            "fax_number": "818-217-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16661 VENTURA BLVD STE 820",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364801",
            "telephone_number": "818-394-0884",
            "fax_number": "818-217-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUYA LAVIAN MD INC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "LAVIAN",
        "authorized_official_first_name": "POUYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-394-0884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "A109429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A109429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.