Nader S Shahid, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Glendora, CA
NPI 1306900873 · NPPES record last updated Mar 20, 2017
Key facts
- NPI
- 1306900873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 20032 (CA)
- Practice address
- 1347 S Grand Ave
Glendora, CA 91740-5046 - Phone
- (626) 857-4711
- Fax
- (626) 857-4712
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Agape Physical Therapy Inc.
Practice addresses (Care Compare)
9689 Base Line Rd
Rancho Cucamonga, CA 91730-1314
Phone (909) 646-3663
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111212000528 | CA | Practitioner - Physical Therapist in Private Practice | 6305011875 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20032 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Rehabilitation Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 20032 | CA | Yes |
Addresses
Primary practice location
1347 S Grand Ave
Glendora, CA 91740-5046
Mailing address
1347 S Grand Ave
Glendora, CA 91740-5046
Phone (626) 857-4711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WPT20032A | Other | CA | PPIN |
Other providers in Glendora, CA
- Puchun Seok
- Serenity Christian Therapy
- Serenity Health Care, Inc.
- Jessica Serrano
- Mary Atalla Shahid
- Nivine Shahid
- Abraham V Shammas
- Shant Tomassian MD Inc
- Stephanie K Sharma
- Shady Sharmouk
All providers in Glendora, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.