Active NPI
Keyvan Amirikhorheh, M.D.
- General Practice Physician
- Los Angeles, CA
National Provider Identifier
1982888152
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Apr 20, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A55422
- Practice address
- 1830 W Olympic Blvd
Unit 124
Los Angeles, CA 90006-3734 - Phone
- (213) 383-1183
- Fax
- (213) 383-1184
- NPI assigned
- Dec 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A55422 | CA | Primary |
Addresses
Primary practice location
1830 W Olympic Blvd
Unit 124
Los Angeles, CA 90006-3734
Mailing address
485 Chinook LN
San Jose, CA 95123-3311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A55422 | Other | CA | CALIFORNIA MEDICAL BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A55422 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1982888152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 CHINOOK LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951233311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 W OLYMPIC BLVD",
"address_2": "UNIT 124",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900063734",
"telephone_number": "213-383-1183",
"fax_number": "213-383-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIRIKHORHEH",
"first_name": "KEYVAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-24",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A55422",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA MEDICAL BOARD",
"identifier": "A55422",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.