Individual provider Active NPI

Mamak Shakib, D.C.

  • Chiropractor
  • Irvine, CA
National Provider Identifier
1265637144
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC21503 Issued in CA
Practice address
15785 Laguna Canyon Rd
Suite 110
Irvine, CA 92618-3165
Phone
(949) 552-5535
Fax
(949) 552-3022
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC21503 CA Primary

Addresses

Primary practice location

15785 Laguna Canyon Rd
Suite 110
Irvine, CA 92618-3165

Mailing address

15785 Laguna Canyon Rd
Suite 110
Irvine, CA 92618-3165
Phone (949) 552-5535

Other names 1

  • Mamak Shakib Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC21503CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1265637144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183165",
            "telephone_number": "949-552-5535",
            "fax_number": "949-552-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15785 LAGUNA CANYON RD",
            "address_2": "SUITE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183165",
            "telephone_number": "949-552-5535",
            "fax_number": "949-552-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIB",
        "first_name": "MAMAK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAMAK",
            "last_name": "SHAKIB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.