Shahram Jacobs M.D., Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A89999 Issued in CA

Legal business name

SHAHRAM JACOBS M.D., INC

Practice address

16133 Ventura Blvd
#340 / 370
Encino, CA 91436-2403

Phone

(818) 981-1555

Fax

(818) 981-1510

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shahram Jacobs, MDNPI 1659439040

Title

President/ Secretary/ Treasurer

Phone

(818) 981-1555

Specialties & licenses 1

Addresses

Other names 1

• SHAHRAM POURRABBANI M.D., INC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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.

• Shahram Jacobs, M.D.

  • Internal Medicine Physician
  • Encino, CA
  • NPI 1659439040
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1952592958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16133 VENTURA BLVD",
            "address_2": "#340 / 370",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362403",
            "telephone_number": "818-981-1555",
            "fax_number": "818-981-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16133 VENTURA BLVD",
            "address_2": "#340 / 370",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362403",
            "telephone_number": "818-981-1555",
            "fax_number": "818-981-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRAM JACOBS M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "PRESIDENT/ SECRETARY/ TREASURER",
        "authorized_official_telephone_number": "818-981-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A89999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHAHRAM POURRABBANI M.D., INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nineli Shahbazian
• Raisa Shahbazian
• Mohamad Shaheedy, MD
• Liana Shahijani, FNP-BC
• Shahin S. Rad, M.D. PC (Los Angeles Bone and Joint Institute)
• Shahram S Farahvash MD Inc
• Shahriari D D S Inc
• Shahriari DDS Inc
• Bahram Edward Shahrokh, PSYD
• Shirin Shahrokhi, LMFT

• Internal Medicine Physician in Encino, CA
• Providers in Encino, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.