KOUROSH ALEXANDER DASTGHEIB, M.D., INC
NPI 1922205202
Ophthalmology in Garden Grove, CA

Q: What is Kourosh Alexander Dastgheib, M.D., Inc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since June 29, 2007CLIA 05D2235514 · Certificate of Compliance

12665 GARDEN GROVE BLVD, STE 301, GARDEN GROVE, CA 92843(949) 652-6966(714) 422-0960 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 17, 2024, Dec 17, 2018 (2 updates tracked since 2018).

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About Kourosh Alexander Dastgheib, M.d., Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOUROSH ALEXANDER DASTGHEIB, M.D., INC (NPI 1922205202) is a healthcare organization registered as an ophthalmology in Garden Grove, California and active in the NPI registry since June 2007. The organization holds a CLIA Certificate of Compliance certificate valid through March 28, 2027, maintains a secondary practice location in Newport Beach, and lists Heather Renee Rowland, Billing/credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1922205202

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameKOUROSH ALEXANDER DASTGHEIB, M.D., INC

Location Address12665 GARDEN GROVE BLVD, STE 301Garden Grove, CA 92843-1917

Mailing Address12665 Garden Grove Blvd Ste 301Garden Grove, CA 92843-1917 · (949) 652-6966 · Fax (714) 422-0960

Phone(949) 652-6966

Fax(714) 422-0960

Organization SubpartNo

Authorized OfficialHeather Renee RowlandBilling/credentialing Manager · (818) 356-4500

Enumeration DateJune 29, 2007

Last NPPES UpdateJuly 17, 20242 updates tracked since enumeration

NPPES CertifiedJuly 17, 2024

✔ NPI 1922205202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

12665 GARDEN GROVE BLVD, Garden Grove, CA 92843

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Secondary Practice Location 1

Location 1520 Superior Ave Ste 335Newport Beach, CA 92663-3672 · Phone (949) 652-6966 · Fax (714) 422-1917

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kourosh Alexander Dastgheib, M.d., Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kourosh Alexander Dastgheib, M.D., Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kourosh Dastgheib, MD

Ophthalmology

NPI 1578523593

12665 GARDEN GROVE BLVD STE 301
Garden Grove, CA 92843

(909) 581-6732

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D2235514

Kourosh Alexander Dastgheib, MD Inc & Bita Adib Bagheri MD · Newport Beach, CA

Active · expires Mar 28, 2027

CLIA Number05D2235514

Laboratory TypePhysician Office

Certificate Effective DateMarch 29, 2025

Certificate Expiration DateMarch 28, 2027

Laboratory DirectorBita Bagheri

Laboratory Phone(949) 236-7900

Laboratory LocationKourosh Alexander Dastgheib, MD Inc & Bita Adib Bagheri MD520 Superior Ave Ste 335, Newport Beach, CA 92663

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kourosh Alexander Dastgheib, M.D., Inc's NPI number?

The NPI number for Kourosh Alexander Dastgheib, M.D., Inc is 1922205202. It was assigned to this organization in the NPPES registry on June 29, 2007.

Where is Kourosh Alexander Dastgheib, M.D., Inc located?

Kourosh Alexander Dastgheib, M.D., Inc is located at 12665 Garden Grove Blvd Ste 301, Garden Grove, CA 92843. The listed phone number is (949) 652-6966.

What is Kourosh Alexander Dastgheib, M.D., Inc's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Kourosh Alexander Dastgheib, M.D., Inc enrolled in Medicare?

Yes. Kourosh Alexander Dastgheib, M.D., Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kourosh Alexander Dastgheib, M.D., Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Ophthalmology) reassigns their Medicare billing to Kourosh Alexander Dastgheib, M.D., Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kourosh Alexander Dastgheib, M.D., Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D2235514) is associated with this NPI, valid through March 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kourosh Alexander Dastgheib, M.D., Inc was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.