Organization Active NPI

Mozhgan Ashtari MD PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Laguna Hills, CA
National Provider Identifier
1962815779
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A111582 Issued in CA
Legal business name
MOZHGAN ASHTARI MD PC
Practice address
23141 Moulton Pkwy Ste 202
Laguna Hills, CA 92653-1241
Phone
(949) 305-2711
Fax
(949) 502-8887
NPI assigned
Jun 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Mrs. Mozhgan Ashtari, MDNPI 1558691451
Title
Ceo/ MD
Phone
(551) 206-5779

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X A111582 CA Primary

Addresses

Primary practice location

23141 Moulton Pkwy Ste 202
Laguna Hills, CA 92653-1241

Mailing address

23141 Moulton Pkwy Ste 202
Laguna Hills, CA 92653-1241
Phone (949) 305-2711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150820010442 CA Part B Supplier - Clinic/Group Practice 0840505855 Receives reassigned benefits from 2 practitioners
Practice locations: Laguna Hills, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1962815779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY STE 202",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531241",
            "telephone_number": "949-305-2711",
            "fax_number": "949-502-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23141 MOULTON PKWY STE 202",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531241",
            "telephone_number": "949-305-2711",
            "fax_number": "949-502-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOZHGAN ASHTARI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "ASHTARI",
        "authorized_official_first_name": "MOZHGAN",
        "authorized_official_title_or_position": "CEO/ MD",
        "authorized_official_telephone_number": "551-206-5779",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A111582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.