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1285395269 NPI number — DR. ERIC CHAGHOURI M.D., A PROFESSIONAL MEDICAL CORPORATION

NPI Number: 1285395269
Health Care Provider/Practitioner: DR. ERIC CHAGHOURI M.D., A PROFESSIONAL MEDICAL CORPORATION

Information about “1285395269” NPI (DR. ERIC CHAGHOURI M.D., A PROFESSIONAL MEDICAL CORPORATION) exists in 1285395269 in HTML format HTML  |  1285395269 in plain Text format TXT  |  1285395269 in PDF (Portable Document Format) PDF  |  1285395269 in an XML format XML  formats.

NPI Number : 1285395269 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285395269",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "DR. ERIC CHAGHOURI M.D., A PROFESSIONAL MEDICAL CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11150 W OLYMPIC BLVD STE 775",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90064-1850",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "424-307-9503",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11150 W OLYMPIC BLVD STE 775",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90064-1850",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "424-307-9503",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/03/2022",
    "LastUpdateDate": "10/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHAGHOURI",
    "AuthorizedOfficialFirstName": "ERIC",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "310-850-8657",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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