Organization Active NPI

Reza Shafee MD Inc.

  • Health Service Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1346403813
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
A85480 Issued in CA
Legal business name
REZA SHAFEE MD INC.
Practice address
2010 E 1St St
Suite 130
Santa Ana, CA 92705-4079
Phone
(714) 916-8728
NPI assigned
Jul 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Dr. Reza Shafee, MDNPI 1275586992
Title
Ceo
Phone
(714) 916-8728

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
Health Service Clinic/Center 261QH0100X A85480 CA Primary

Addresses

Primary practice location

2010 E 1St St
Suite 130
Santa Ana, CA 92705-4079

Mailing address

2010 E 1St St
Suite 130
Santa Ana, CA 92705-4079

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130212000465 CA Part B Supplier - Clinic/Group Practice 7012161490 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Ana, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2062669Reza Shafee, MD2010 E First Street, #130, Santa Ana, CA 92705Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Locations

2321 E 4th St
Ste 260
Santa Ana, CA 92705

2010 E 1st St
#130
Santa Ana, CA 92705
Phone (714) 836-3540

2321 E 4th St
Santa Ana, CA 92705

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1346403813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST",
            "address_2": "SUITE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST",
            "address_2": "SUITE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054079",
            "telephone_number": "714-916-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA SHAFEE MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-05",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "SHAFEE",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-916-8728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "A85480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.