NPIMap

Organization Active NPI

Mian Mohsin Shah AMC

  • Neurological Surgery Physician
  • Santa Ana, CA
National Provider Identifier
1487931440
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A066315 Issued in CA
Legal business name
MIAN MOHSIN SHAH AMC
Practice address
999 N Tustin Ave
Suite 109
Santa Ana, CA 92705-3528
Phone
(714) 973-1388
Fax
(949) 284-0604
NPI assigned
Nov 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Dr. Mian Mohsin Shah, MD
Title
President and Ceo
Phone
(714) 973-1388

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207T00000X A066315 CA Primary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X A066315 CA
Vascular Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084V0102X A066315 CA
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X A066315 CA

Addresses

Primary practice location

999 N Tustin Ave
Suite 109
Santa Ana, CA 92705-3528

Mailing address

999 N Tustin Ave
Suite 109
Santa Ana, CA 92705-3528
Phone (714) 973-1388

Other identifiers 1

IdentifierTypeStateIssuer
00A663150MedicaidCA

Other names 1

  • IRVINE NEUROLOGICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111227000757 CA Part B Supplier - Clinic/Group Practice 0648446591 Receives reassigned benefits from 1 practitioner
Practice locations: Downey, CA

National Provider Directory

National Provider Directory

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": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1487931440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE 109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-973-1388",
            "fax_number": "949-284-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE 109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-973-1388",
            "fax_number": "949-284-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAN MOHSIN SHAH AMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MIAN",
        "authorized_official_middle_name": "MOHSIN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "714-973-1388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A066315",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A066315",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "A066315",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A066315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A663150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRVINE NEUROLOGICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.