Ava T Shamban, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G50969 Issued in CA

Practice address

2021 Santa Monica Blvd
Suite 600E
Santa Monica, CA 90404

Phone

(310) 828-2282

Fax

(310) 828-8504

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ava T Shamban MD IncGroup PAC ID 9931136892, 2 clinicians

Ava Shamban a Medical CorporationGroup PAC ID 5698890846, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ava Shamban a Medical Corporation

  • Dermatology Physician
  • Beverly Hills, CA
  • NPI 1093035479
  Medicare reassignment Care Compare group NPD Authorized official
• Ava T Shamban MD Inc

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1528246196
  Medicare reassignment Care Compare group NPD Authorized official
• Fountain Resources, Inc.

  • Nutritionist
  • Beverly Hills, CA
  • NPI 1104151273
  NPD (past)
• R. Sonia Batra, M.D., Inc.

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1558502690
  NPD (past)
• The Regents of the University of California

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1982849105
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1003922162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 600E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042166",
            "telephone_number": "310-828-2282",
            "fax_number": "310-828-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "SUITE 600E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-828-2282",
            "fax_number": "310-828-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBAN",
        "first_name": "AVA",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G50969",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G50969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minoo Shahriary, BS
• Seyed H Shahrokni, M.D.
• Robert Andries Shain, MD
• Shalabh Puri DDS Inc.
• Cristina Shallenberger, N.P.
• Shamjaden Amersi, a Medical Incorporation
• Shana Shamloo, PSY.D.
• Jaime Marie Shamonki, M.D.
• Shahrad Radi Shamsi, M.D.
• Alan Shan

• Dermatology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.