Active NPI
Nima Sharif Mahallati, D.C, B.S, CMT
- Chiropractor
- Oakland, CA
National Provider Identifier
1497005300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 33575
- Practice address
- 230 Grand Ave Ste 202
Oakland, CA 94610-4559 - Phone
- (404) 993-1140
- NPI assigned
- Sep 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR008617 | GA | |
| Chiropractor | 111N00000X | 33575 | CA | Primary |
Addresses
Primary practice location
230 Grand Ave Ste 202
Oakland, CA 94610-4559
Mailing address
24065 Madeiros Ave
Hayward, CA 94541-4462
Phone (404) 993-1140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33575 | CA | MD | Mental Health Counselor |
| CHIR008617 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471564800000",
"number": "1497005300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24065 MADEIROS AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945414462",
"telephone_number": "404-993-1140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 GRAND AVE STE 202",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946104559",
"telephone_number": "404-993-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHALLATI",
"first_name": "NIMA",
"middle_name": "SHARIF",
"credential": "D.C, B.S, CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-18",
"last_updated": "2016-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR008617",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "33575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.