Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1770144016 Individual Practitioner Male Practitioner

Dr. Khashayar Ebrahimzadeh , MD

Pediatrics • Blythe, CA

Professional Overview & Biography Verified Profile Summary

Dr. Khashayar Ebrahimzadeh, MD is a registered healthcare professional specializing in Pediatrics in Blythe, CA. Practice services are available at 1415 W HOBSONWAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1415 W Hobsonway

Blythe, CA 922251479

Telephone 7609224981
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Blythe, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
2 Specialists

Practicing in Blythe, CA (9612 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-07
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CA A176374

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License MI 4351045098

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
4351045098 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1417079989

Doctor of Medicine (M.D.)

Dr. William Hoolihan , DDS

Dentist - General Practice

NPI 1457371601

Doctor of Dental Surgery

NPI 1497361638

Doctor of Nursing Practice, Family Nurse Practitioner (Board Certified)

Patricia Mccallister , ARNP

Nurse Practitioner - Family

NPI 1508069071

Advanced Registered Nurse Practitioner

Funmi Olukoya , ARNP, FNP

Nurse Practitioner - Family

NPI 1629307202

Advanced Registered Nurse Practitioner, Family Nurse Practitioner

Samantha Varghese , PA-C

Physician Assistant

NPI 1912390147

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location February 07, 2025

Registered at 1415 W HOBSONWAY, BLYTHE, CA 922251479 (Tel: 7609224981)

📍
Updated Business Mailing Address February 07, 2025

Registered at 1415 W HOBSONWAY, BLYTHE, CA 922251479 (Tel: 7609224981)

📍
Updated Practice Location August 22, 2022

Registered at 321 W HOBSONWAY STE C, BLYTHE, CA 922251651 (Tel: 7609224981)

📍
Updated Business Mailing Address August 22, 2022

Registered at 321 W HOBSONWAY STE C, BLYTHE, CA 922251651 (Tel: 7609224981)

NPI Profile Active June 26, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location June 26, 2019

Registered at 5303 S CEDAR ST STE 205, LANSING, MI 489113800 (Tel: 5178874305)

📍
Updated Business Mailing Address June 26, 2019

Registered at PO BOX 30161, LANSING, MI 489097661 (Tel: 5178874305)

👤
Provider Name / Credentials Updated June 26, 2019

Recorded as KHASHAYAR EBRAHIMZADEH, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2019

Pediatrics (License #4351045098 in MI)

🟢
Initial NPI Registration & Enumeration June 26, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770144016
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2019
Last Update: February 07, 2025
Sole Proprietor: Yes

Mailing Address

1415 W Hobsonway

Blythe, CA 922251479

Phone: 7609224981

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.