NPI Record of DR. PEYMAN BENHARASH MD NPI 1003000639

Surgery in Los Angeles, CA

Complete NPI Record

Field Name Value Definition
NPI1003000639The 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 Code1Code 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 Last Name Legal NameBENHARASHThe last name of the provider. If the provider is an individual, this is the legal name.
Provider First NamePEYMANThe first name of the provider, if the provider is an individual.
Provider Name Prefix TextDR.The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential TextMDThe 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 First Line Business Mailing Address5767 W CENTURY BLVDThe 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 400The 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 ANGELESThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe 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 Code900455631The 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 USThe 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 First Line Business Practice Location Address10833 LECONTE AVE ROOM 62-215The 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 NameLOS ANGELESThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code900950001The 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 USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number3102066717The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3102065901The fax number associated with the location address of the provider being identified.
Provider Enumeration Date8/27/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date11/18/2019The date that a record was last updated or changed.
Provider Gender CodeMThe code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1208600000XCode 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 1A85379The 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 1CAThe 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 1Y
Other Provider Identifier 100A853790Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1CA
Is Sole ProprietorNCode indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No