DR. BEHNAM DAVID MASSABAND DPM, NPI 1760481741 — LOS ANGELES (CA)

NPI 1760481741

14+ Years Experience Individual

DR. BEHNAM DAVID MASSABAND DPM

07/20/2005
PROVIDER ENUMERATION DATE
11.07.2011
LAST UPDATE DATE
1760481741
NPI NUMBER

About DR. BEHNAM DAVID MASSABAND

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

DR. BEHNAM DAVID MASSABAND is a provider established in LOS ANGELES, CA. The NPI number of DR. BEHNAM DAVID MASSABAND is 1760481741 and was assigned on 07/20/2005. The practitioners primary taxonomy code is: 213ES0103X with license number: E3989 CA .

Mailing address

  • City: LOS ANGELES
  • State: CA
  • Postal code: 900485901
  • Phone: 3106572828
  • Address: 8631 W 3RD ST
  • Address 2: SUITE 940-E

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1760481741
  • Phone : 3106572828
  • Postalcode : 900485901
  • Address : 8631 W 3RD ST SUITE 940-E

Additional identifiers

  • Identifier: 000E39891
  • Code / Type : 5 - MEDICAID
  • Identifier state : CA

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 000E39892
  • Code / Type : 5 - MEDICAID
  • Identifier state : CA

Provider taxonomy - Podiatrist

  • Taxonomy code: 213ES0103X
  • License number: E3989
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • DR. BEHNAM DAVID MASSABAND DPM
  • Address : 8631 W 3RD ST SUITE 940-E
  • Region : LOS ANGELES, CA
  • NPI : 1760481741
  • Phone : 3106572828
  • Postalcode : 900485901

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address8631 W 3RD ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 940-E
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900485901
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3106572828
The telephone number associated with the location address of the provider being identified.
NPI1760481741
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1213ES0103X
Provider Enumeration Date07/20/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated11.07.2011
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. BEHNAM DAVID MASSABAND
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address8631 W 3RD ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 940-E
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameLOS ANGELES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code900485901
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3106572828
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1213ES0103X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Podiatrist
Provider License Number 1E3989
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1000E39891
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1CA
Other Provider Identifier State #1
Other Provider Identifier 2000E39892
Other Provider Identifier #2
Other Provider Identifier Type 25
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2CA
Other Provider Identifier State #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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