Individual provider Active NPI

Nasser Shekib, M.D.

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1245320795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A051076 Issued in CA
Practice address
11819 Wilshire BL.
Suite # 213
Los Angeles, CA 90025
Phone
(310) 312-0150
Fax
(310) 312-9939
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A051076 CA Primary

Addresses

Primary practice location

11819 Wilshire BL.
Suite # 213
Los Angeles, CA 90025

Mailing address

11870 Idaho Ave
Suite# 301
Los Angeles, CA 90025-2897
Phone (310) 312-0150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A051076CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245320795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11870 IDAHO AVE",
            "address_2": "SUITE# 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252897",
            "telephone_number": "310-312-0150",
            "fax_number": "310-312-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11819 WILSHIRE BL.",
            "address_2": "SUITE # 213",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-312-0150",
            "fax_number": "310-312-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKIB",
        "first_name": "NASSER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A051076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.