Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mastaneh Nikravesh, MD

Individual provider Internal Medicine Physician · NPI 1508429143

Mastaneh Nikravesh, MD is an Internal Medicine in LA Mesa, California. Qualified in 2019, 7 years ago. Practices with Zachary C Cohen MD APC, a 15-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5555 Grossmont Center Dr
LA Mesa, CA 91942-3019
Phone: (619) 740-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3434 Midway Dr Ste 2001, San Diego, CA 92110-4924 — (619) 325-1161

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X · Licence A176795 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence A176795 (CA)
Addiction Medicine (Preventive Medicine) Physician Taxonomy 2083A0300X · Licence A176795 (CA)

Record details

NPI number1508429143
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2019
Last updated in NPPESMarch 11, 2025
Certification dateMarch 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Zachary C Cohen Md Apc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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