M Shokraei MD Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

A53012B Issued in CA

Legal business name

M SHOKRAEI MD INC

Practice address

6670 Reseda Blvd
Suite # 105
Reseda, CA 91335-5327

Phone

(818) 881-0671

Fax

(818) 881-7762

NPI assigned

Mar 3, 2007

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohammad T Shokraei, M.D.

Title

President

Phone

(818) 881-0671

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1952430324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491221",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900499221",
            "telephone_number": "818-881-0671",
            "fax_number": "818-881-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 RESEDA BLVD",
            "address_2": "SUITE # 105",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355327",
            "telephone_number": "818-881-0671",
            "fax_number": "818-881-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M SHOKRAEI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-03",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SHOKRAEI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-881-0671",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "A53012B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC. NO.",
            "identifier": "A53012B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Reseda, CA
• Providers in Reseda, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.