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DR. KHOSROW MAHDAVI MD NPI 1275536773


NPI Information

NPI: 1275536773
Provider Name: DR. KHOSROW MAHDAVI, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

PECOS Registration: Yes

Address:
1640 NEWPORT BLVD STE 400
COSTA MESA, CA
ZIP 92627
Phone: (949) 999-2400
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DR. Khosrow Mahdavi, MD is a hematology and oncology internal medicine in Costa Mesa, CA with 55 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. DR. Khosrow Mahdavi, MD NPI is 1275536773. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1640 NEWPORT BLVD STE 400
COSTA MESA, CA
ZIP 92627-786
Phone: (949) 999-2400

The NPI 1275536773 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/27/2005 and was last updated on 11/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0000XInternal MedicineHematologyA33589CALIFORNIANo
2174400000XSpecialistA33589CALIFORNIANo
3207RX0202XInternal MedicineMedical OncologyA33589CALIFORNIANo
4207RH0003XInternal MedicineHematology & OncologyA33589CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A33589OTHERCALIFORNIALICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.