Organization Active NPI

Tahseen Shareef MD, Inc

  • Internal Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1295132298
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G84109 Issued in CA
Legal business name
TAHSEEN SHAREEF MD, INC
Practice address
11374 Mountain View Ave Ste A1
Loma Linda, CA 92354-3830
Phone
(909) 203-3825
Fax
(909) 799-3888
NPI assigned
Nov 20, 2014
Last updated
Dec 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Dr. Tahseen Shareef, M.D.NPI 1669491809
Title
Physician
Phone
(909) 203-3825

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 Physician 207R00000X G84109 CA Primary

Addresses

Primary practice location

11374 Mountain View Ave Ste A1
Loma Linda, CA 92354-3830

Mailing address

11374 Mountain View Ave Ste A1
Loma Linda, CA 92354-3830
Phone (909) 203-3825

Other identifiers 1

IdentifierTypeStateIssuer
00G841090MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150420000833 CA Part B Supplier - Clinic/Group Practice 7113245382 Receives reassigned benefits from 1 practitioner
Practice locations: Loma Linda, CA; Grand Terrace, CA; Lake Arrowhead, CA; Chino Hills, CA

National Provider Directory

National Provider Directory

Locations

22573 Barton Rd
Ste A
Grand Terrace, CA 92313
Phone (909) 230-3825

11374 Mountain View Ave
Ste A1
Loma Linda, CA 92354
Phone (909) 203-3825

Practitioners & affiliated clinicians

Practitioners 2

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": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1295132298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11374 MOUNTAIN VIEW AVE STE A1",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543830",
            "telephone_number": "909-203-3825",
            "fax_number": "909-799-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11374 MOUNTAIN VIEW AVE STE A1",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543830",
            "telephone_number": "909-203-3825",
            "fax_number": "909-799-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHSEEN SHAREEF MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "SHAREEF",
        "authorized_official_first_name": "TAHSEEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "909-203-3825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G84109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G841090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.