Keyvan Malekshamran, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A94845 Issued in CA

Practice address

1121 E Washington Ave
Escondido, CA 92025-2214

Phone

(760) 871-0606

NPI assigned

Dec 27, 2006

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neighborhood Healthcare

  dba Neighborhood Healthcare - Escondido

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1598703647
  Medicare reassignment NPD
• Dap Health, Inc.

  dba DAP Health-Borrego Springs Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Borrego Springs, CA
  • NPI 1134144165
  NPD
• Neighborhood Healthcare

  dba Neighborhood Healthcare - Beaumont

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD
• County of Ventura

  dba Ventura County Medical Center

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  NPD (past)
• Eastern Rio Blanco County Health Service District

  dba Pioneers Medical Center

  • Skilled Nursing Facility
  • Meeker, CO
  • NPI 1306944822
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1952466112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69175 RAMON RD STE A",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343344",
            "telephone_number": "760-321-6776",
            "fax_number": "760-321-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E WASHINGTON AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252214",
            "telephone_number": "760-871-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "69175 Ramon Rd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Cathedral City",
            "state": "CA",
            "postal_code": "922343344",
            "country_code": "US",
            "telephone_number": "760-321-6776",
            "fax_number": "760-321-4036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALEKSHAMRAN",
        "first_name": "KEYVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A94845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "W3731",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "WA94845A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Makey
• Carmen I. Maldonado, MFTI, PCCI
• Marissa Maldonado
• Ruth Maldonado, M.S., CCC-SLP
• Mikhail R Malek, M.D.
• Christo George Mallakis, D.M.D.
• Richard Mallo, MD
• Leondra Mallory, FSD, LEC, CBE
• Kaya Tiffany Malone
• Robert Joseph Malone, DDS

• Pediatrics Physician in Escondido, CA
• Providers in Escondido, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.