Peyman Shakiba, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00047591 Issued in WA

Practice address

480 Alta Rd
San Diego, CA 92179-0001

Phone

(619) 661-6500

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of California Prison Industry Authority

  • Eyewear Supplier
  • San Diego, CA
  • NPI 1356558001
  NPD (past)
• County of Clackamas Office of County Auditor

  dba Hilltop Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457379380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212612",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919212612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-661-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 SW US Veterans Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392964",
            "country_code": "US",
            "telephone_number": "360-696-4061 x33149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAKIBA",
        "first_name": "PEYMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00047591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Shaker, RN
• Mohammed Shaker, MD, PHD
• Shahbanoo Shery Shakerifar
• Ava Shakib-Cocks, LCSW
• Kayla Shakiba I, SLPA
• Fatima Ein Shakil
• Afaaf Ishrat Shakir, MD
• Gideon Mordechai Shakked, RPH
• Farah Palomas Shakoori, REGISTERED DIETITIAN
• Kelly Shakya

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.