Individual provider Active NPI

Heba Marzouk Al-Shoubaki, PA-C

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1548867666
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58597 Issued in CA
Practice address
2501 E Chapman Ave Ste 306
Orange, CA 92869-3204
Phone
(714) 628-3230
NPI assigned
Oct 1, 2020
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA58597 CA Primary

Addresses

Primary practice location

2501 E Chapman Ave Ste 306
Orange, CA 92869-3204

Mailing address

2501 E Chapman Ave Ste 306
Orange, CA 92869-3204
Phone (714) 628-3230

Other practice location 1

505 E Commonwealth Ave
Fullerton, CA 92832-2020
Phone (714) 399-4571

Other practice location 2

201 S Buena Vista St Ste 100
Burbank, CA 91505-4570
Phone (818) 848-6404

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
I20210108002530 CA Practitioner - Physician Assistant 2668885740 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians
Premier Cardiology IncGroup PAC ID 0143365536, 7 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

401 Old Newport Blvd
Suite 201
Newport Beach, CA 92663-4289
Phone (949) 478-7373

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-3022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as apm
Quality
84.3
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58597CAMDOrthodontics and Dentofacial Orthopedic Dentist
PA58597CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Feb 9, 2026 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2024 Accepting new patients
Providence Medical Foundation CurrentSince Nov 4, 2024 Accepting new patients
Providence Medical Institute CurrentSince Feb 9, 2026 Accepting new patients
Providence Medical Foundation CurrentSince Nov 4, 2024 Accepting new patients
Providence Medical Institute Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

201 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 848-6404

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

File 57326
Los Angeles, CA 90074

2501 E Chapman Ave
Ste 306
Orange, CA 92869
Phone (714) 628-3230

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 9

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1548867666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 306",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-628-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 306",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693204",
            "telephone_number": "714-628-3230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Commonwealth Ave",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928322020",
            "country_code": "US",
            "telephone_number": "714-399-4571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S Buena Vista St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915054570",
            "country_code": "US",
            "telephone_number": "818-848-6404",
            "fax_number": "818-848-7112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-SHOUBAKI",
        "first_name": "HEBA",
        "middle_name": "MARZOUK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.