Organization Active NPI

Moataz Giurgius M D Inc

  • Psychiatry Physician
  • Yorba Linda, CA
National Provider Identifier
1275570756
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A53359 Issued in CA
Legal business name
MOATAZ GIURGIUS M D INC
Practice address
20409 Yorba Linda Blvd Suite K2-265
Yorba Linda, CA 92886-3042
Phone
(562) 947-8832
Fax
(562) 947-8839
NPI assigned
Jun 1, 2006
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Dr. Shadee Giurgius, M.D.NPI 1376170100
Title
Director
Phone
(562) 947-8832

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
Psychiatry Physician 2084P0800X A53359 CA Primary

Addresses

Primary practice location

20409 Yorba Linda Blvd Suite K2-265
Yorba Linda, CA 92886-3042

Mailing address

20409 Yorba Linda Blvd Ste K2-265
Yorba Linda, CA 92886-3042
Phone (562) 947-8832

Other identifiers 1

IdentifierTypeStateIssuer
00A533592MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510000609 CA Part B Supplier - Clinic/Group Practice 6709875339 Receives reassigned benefits from 2 practitioners
Practice locations: Yorba Linda, CA

National Provider Directory

National Provider Directory

Locations

12675 La Mirada Blvd
Ste 419
La Mirada, CA 90638
Phone (562) 906-8832

15651 Imperial Hwy
Ste 203
Lamirada, CA 90638
Phone (562) 947-8832

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1275570756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD STE K2-265",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "562-947-8832",
            "fax_number": "562-947-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD SUITE K2-265",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "562-947-8832",
            "fax_number": "562-947-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOATAZ GIURGIUS M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "GIURGIUS",
        "authorized_official_first_name": "SHADEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "562-947-8832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A53359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A533592",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.