Shima Hadidchi MD a Professional Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHIMA HADIDCHI MD A PROFESSIONAL CORP

Practice address

12740 Hesperia Rd Ste a
Victorville, CA 92395-8306

Phone

(760) 998-1999

Fax

(760) 881-3555

NPI assigned

Aug 22, 2019

Organization subpart

No

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

Authorized official

Name

Shima Hadidchi, MDNPI 1780975839

Title

Owner

Phone

(760) 998-1999

Specialties & licenses 1

Addresses

Other names 1

• SHIMA HADIDCHI MD A PROFESSIONAL CORP Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EECJBD

Practitioners 3

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

• Shima Hadidchi, M.D.

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1780975839
  Medicare reassignment Care Compare group Authorized official
• Aeleen Charife Bird, NP

  • Family Nurse Practitioner
  • Victorville, CA
  • NPI 1649031345
  Medicare reassignment Care Compare group NPD
• Brett Bird, NP

  • Gerontology Nurse Practitioner
  • Victorville, CA
  • NPI 1780453191
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582934400000",
    "number": "1225685332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-245-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-998-1999",
            "fax_number": "760-881-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIMA HADIDCHI MD A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A",
        "authorized_official_last_name": "HADIDCHI",
        "authorized_official_first_name": "SHIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-998-1999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHIMA HADIDCHI MD A PROFESSIONAL CORP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHIMA HADIDCHI MD A PROFESSIONAL CORP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelton Family Therapy, Inc.
• Julie Shen, DDS
• Sherylann Wade, M.D., Inc.
• Makoto Shibutani
• Shiloh Medical Center Inc
• Shima Hadidchi MD a Professional Corp
• Amanda Shin, DPT
• Andrew Woochul Shin, D.D.S
• Hyun Joon Shin, DDS
• Young Shin, DPT

• Family Medicine Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.