Kianoush Shakib MD Inc

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

Legal business name

KIANOUSH SHAKIB MD INC

Practice address

11661 San Vicente Blvd Ste 101
Los Angeles, CA 90049-5150

Phone

(310) 312-1231

NPI assigned

Jan 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Kianoush Shakib, MD

Title

President

Phone

(917) 669-7949

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1205309341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 SAN VICENTE BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495150",
            "telephone_number": "310-312-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 SAN VICENTE BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495150",
            "telephone_number": "310-312-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIANOUSH SHAKIB MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "SHAKIB",
        "authorized_official_first_name": "KIANOUSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-669-7949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emily Eriko Kiba, L.AC.
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• Kid'S Path Pediatric Therapy Services

• Allergy & Immunology (Internal Medicine) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Allergy & Immunology (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.