Individual provider Active NPI

Shahbaz Khan

  • Psychiatry Physician
  • Concord, CA
National Provider Identifier
1619048295
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A53269 Issued in CA
Practice address
1420 Willow Pass Rd
Concord, CA 94520-5223
Phone
(925) 646-5480
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A53269 CA Primary

Addresses

Primary practice location

1420 Willow Pass Rd
Concord, CA 94520-5223

Mailing address

1420 Willow Pass Rd
Concord, CA 94520-5223
Phone (925) 646-5480

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000399 CA Practitioner - Psychiatry 7416025002 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Contra Costa CountyGroup PAC ID 8628052974, 74 clinicians
Comprehensive Psychiatric Services a Medical GroupGroup PAC ID 0244329969, 74 clinicians

Practice addresses (Care Compare)

2523 El Portal Dr
Suite 101
San Pablo, CA 94806-3305
Phone (510) 215-3730

3100 Oak Rd
Suite 270
Walnut Creek, CA 94597-2078
Phone (925) 944-9711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53269CAMDGeneral Practice Dentistry
A53269CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Mar 27, 2019 Accepting new patients
Comprehensive Psychiatric Services, a Medical Group Psychiatry CurrentSince Jul 1, 2008 Accepting new patients
Contra Costa County Current Accepting new patients
Contra Costa County CurrentSince Mar 27, 2019 Accepting new patients
Contra Costa County PastSince Oct 2, 2022 Accepting new patients

Locations

5924 Stoneridge Dr
Ste 210
Pleasanton, CA 94588
Phone (925) 223-6157

333 University Ave
Ste 200
Sacramento, CA 95825
Phone (707) 864-6860

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

2523 El Portal Dr
Ste 101
San Pablo, CA 94806
Phone (510) 215-3700

3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711

Organizations & group practices 5

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.

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1619048295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205223",
            "telephone_number": "925-646-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205223",
            "telephone_number": "925-646-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHBAZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A53269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.