Organization Active NPI

Morteza Dowlatshahi M D Inc

  • Specialist
  • San Jose, CA
National Provider Identifier
1972644797
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MORTEZA DOWLATSHAHI M D INC
Practice address
200 Jose Figueres Ave
Suite 199
San Jose, CA 95116-1500
Phone
(408) 729-4673
Fax
(408) 729-9943
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Morteza Dowlatshahi, M.D.NPI 1437112158
Title
President
Phone
(408) 729-4673

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

200 Jose Figueres Ave
Suite 199
San Jose, CA 95116-1500

Mailing address

PO Box 743095
Los Angeles, CA 90074-3095
Phone (408) 729-4673

Other practice location 1

18511 Mission View Dr Ste 140
Morgan Hill, CA 95037-2975
Phone (408) 779-1400

Other names 1

  • Cancer Care Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707001043 CA Part B Supplier - Clinic/Group Practice 4688610918 Receives reassigned benefits from 2 practitioners
Practice locations: Morgan Hill, CA; San Jose, CA

National Provider Directory

National Provider Directory

Locations

725 E Santa Clara St
Ste 103
San Jose, CA 95112
Phone (408) 457-7100

Practitioners & affiliated clinicians

Practitioners 4

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1972644797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743095",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743095",
            "telephone_number": "408-729-4673",
            "fax_number": "408-729-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE",
            "address_2": "SUITE 199",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161500",
            "telephone_number": "408-729-4673",
            "fax_number": "408-729-9943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18511 Mission View Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Morgan Hill",
            "state": "CA",
            "postal_code": "950372975",
            "country_code": "US",
            "telephone_number": "408-779-1400",
            "fax_number": "408-779-1422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MORTEZA DOWLATSHAHI M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "DOWLATSHAHI",
        "authorized_official_first_name": "MORTEZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-729-4673",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Care Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.