Misha Shah Freyaldenhoven, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

C50374 Issued in CA

Practice address

1288 Morro St Ste 200
San Luis Obispo, CA 93401-6302

Phone

(805) 543-1233

Fax

(805) 547-1179

NPI assigned

Jun 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Misha Shah Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437352739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 MORRO ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016302",
            "telephone_number": "805-543-1233",
            "fax_number": "805-547-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 MORRO ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016302",
            "telephone_number": "805-543-1233",
            "fax_number": "805-547-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYALDENHOVEN",
        "first_name": "MISHA",
        "middle_name": "SHAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C50374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C50374",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISHA",
            "last_name": "SHAH",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heidi M. Freeman, M.D.
• John Alexander Freeman, D.D.S., M.S.D.
• Matthew R Freeman, PT
• Travis Freitas
• Lillian Frey
• Ramona Fridman, PH.D.
• Sandy Lee Friedeck, LPT
• Sanford Louis Friedlander, LMFT
• Jeffrey Steven Friedman, PH.D.
• Sharon Lillian Friedmann, LMFT

• Specialist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.