Individual provider Active NPI

Andrew Shahbazian

  • Student in an Organized Health Care Education/Training Program
  • Upland, CA
National Provider Identifier
1306430046
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
39151 Issued in CA
Practice address
2122 W Arrow Rte Apt 733
Upland, CA 91786-8848
Phone
(818) 397-1036
NPI assigned
Feb 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 39151 CA Primary

Addresses

Primary practice location

2122 W Arrow Rte Apt 733
Upland, CA 91786-8848

Mailing address

2122 W Arrow Rte Apt 733
Upland, CA 91786-8848
Phone (818) 397-1036

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

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1306430046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 W ARROW RTE APT 733",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868848",
            "telephone_number": "818-397-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 W ARROW RTE APT 733",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868848",
            "telephone_number": "818-397-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBAZIAN",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "39151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.