NPIMap

Organization Active NPI

Fariborz Shams, DO Inc.

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1215107495
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A6510 Issued in CA
Legal business name
FARIBORZ SHAMS, DO INC.
Practice address
515 S Beach Blvd Ste F
Anaheim, CA 92804-1812
Phone
(714) 995-7503
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Dr. Fariborz Shams, DONPI 1063421865
Title
Physician/Owner
Phone
(714) 995-7503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A6510 CA Primary

Addresses

Primary practice location

515 S Beach Blvd Ste F
Anaheim, CA 92804-1812

Mailing address

515 S Beach Blvd Ste F
Anaheim, CA 92804-1812
Phone (714) 995-7503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080416000679 CA Part B Supplier - Clinic/Group Practice 9739267709 Receives reassigned benefits from 5 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

515 S Beach Blvd
Ste F
Anaheim, CA 92804
Phone (714) 995-7503

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1215107495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-995-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD STE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-995-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIBORZ SHAMS, DO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "SHAMS",
        "authorized_official_first_name": "FARIBORZ",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "714-995-7503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A6510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.