Individual provider Active NPI

Shirin Rabbanian, PA-C

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1487524914
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
22500 Issued in CA
Practice address
11825 Major St Ste 107
Los Angeles, CA 90230-6356
Phone
(310) 915-6100
NPI assigned
Nov 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 22500 CA Primary

Addresses

Primary practice location

11825 Major St Ste 107
Los Angeles, CA 90230-6356

Mailing address

11825 Major St Ste 107
Los Angeles, CA 90230-6356
Phone (310) 915-6100

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260121001189 CA Practitioner - Physician Assistant 2567949613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next Phase Medical PCGroup PAC ID 5890271951, 3 clinicians

Practice addresses (Care Compare)

11825 Major St
Suite 107
Culver City, CA 90230-6356
Phone (310) 915-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22500CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Physical Therapy, Inc CurrentSince Nov 18, 2025 Accepting new patients
Next Phase Medical PC CurrentSince Nov 24, 2025 Accepting new patients

Locations

11825 Major St
Ste 107
Los Angeles, CA 90230
Phone (310) 915-6100

322 Culver Blvd
Playa del Rey, CA 90293
Phone (310) 461-8712

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1487524914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 MAJOR ST STE 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "902306356",
            "telephone_number": "310-915-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11825 MAJOR ST STE 107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "902306356",
            "telephone_number": "310-915-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABBANIAN",
        "first_name": "SHIRIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "22500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.