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  7. NPI Record 1780773721

DR. HMA MAHDAVI M.D.
Complete NPI Record 1780773721
Pediatrics - Pediatric Nephrology in Long Beach, CA

NPI Status: Active since October 11, 2006

Contact Information

1760 TERMINO AVE STE 214
LONG BEACH, CA
ZIP 90804
Phone: (562) 933-6933
Fax: (562) 933-6939

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Name Prefix Text
  6. Provider Credential Text
  7. Provider Other Last Name
  8. Provider Other First Name
  9. Provider Other Middle Name
  10. Provider Other Name Prefix Text
  11. Provider Other Credential Text
  12. Provider Other Last Name Type Code
  13. Provider First Line Business Mailing Address
  14. Provider Business Mailing Address City Name
  15. Provider Business Mailing Address State Name
  16. Provider Business Mailing Address Postal Code
  17. Provider Business Mailing Address Country Code If outside U S
  18. Provider Business Mailing Address Telephone Number
  19. Provider Business Mailing Address Fax Number
  20. Provider First Line Business Practice Location Address
  21. Provider Business Practice Location Address City Name
  22. Provider Business Practice Location Address State Name
  23. Provider Business Practice Location Address Postal Code
  24. Provider Business Practice Location Address Country Code If outside U S
  25. Provider Business Practice Location Address Telephone Number
  26. Provider Business Practice Location Address Fax Number
  27. Provider Enumeration Date
  28. Last Update Date
  29. Provider Gender Code
  30. Healthcare Provider Taxonomy Code 1
  31. Provider License Number 1
  32. Provider License Number State Code 1
  33. Healthcare Provider Primary Taxonomy Switch 1
  34. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1780773721. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1780773721
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
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).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: HMA
The first name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: M.D.
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name: PEZESHKIAN
Other last name by which the provider being identified is or has been known.
Provider Other First Name: HOMA
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Middle Name: MAHDAVI
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider is or has been known by a different last name only.
Provider Other Name Prefix Text: DR.
The other name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Other Credential Text: M.D.
The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name Type Code: 5
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 6101 BALL RD STE 310
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 Business Mailing Address City Name: CYPRESS
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: CA
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 Code: 906303966
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 Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 7142209486
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’’.
Provider Business Mailing Address Fax Number: 7142209481
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1760 TERMINO AVE STE 214
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 Business Practice Location Address City Name: LONG BEACH
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 908042169
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 Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5629336933
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 5629336939
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/11/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/8/2007
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 2080P0210X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: A72759
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: CA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No