Shidban Dialysis Access Inc

Primary specialty

Transplant Surgery PhysicianTaxonomy code 204F00000X

Legal business name

SHIDBAN DIALYSIS ACCESS INC

Practice address

1414 S Grand Ave Ste 100
Los Angeles, CA 90015-3071

Phone

(213) 797-6044

Fax

(213) 481-7023

NPI assigned

Dec 1, 2023

Organization subpart

No

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

Authorized official

Name

Hamid Shidban, MDNPI 1942246111

Title

Owner

Phone

(213) 797-6044

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hamid Shidban, MD

  • Vascular Surgery Physician
  • Los Angeles, CA
  • NPI 1942246111

  Transplant Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1154197911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILSHIRE BLVD APT 3101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171953",
            "telephone_number": "213-797-6044",
            "fax_number": "213-481-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S GRAND AVE STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153071",
            "telephone_number": "213-797-6044",
            "fax_number": "213-481-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIDBAN DIALYSIS ACCESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "SHIDBAN",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-797-6044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Transplant Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Sun Shibata, DPM
• Jeffrey Shibata
• Seiji Bruce Shibata, M.D. PH.D.
• Vivian Phan Shibayama, O.D.
• Justin Shibel, ATC
• Hamid Shidban, MD
• Jennifer Shieh
• Kate Yang Shieh, M.D.
• Pamela Shieh, PHARM.D.
• Perry Boryee Shieh, MD

• Transplant Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Transplant Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.