Individual provider Active NPI

Randall John Shahbazian, M.D.

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1629253836
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A85058 Issued in CA
Practice address
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone
(559) 453-6599
Fax
(559) 453-8234
NPI assigned
Jan 7, 2008
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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 A85058 CA Primary

Addresses

Primary practice location

4441 E Kings Canyon Rd
Fresno, CA 93702-3604

Mailing address

PO Box 11800
Fresno, CA 93775-1800
Phone (559) 453-6599

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
I20090305000304 CA Practitioner - Psychiatry 6800952458 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kings View Psychiatry CurrentSince Jul 5, 2024 Accepting new patients
Kings View CurrentSince Jul 5, 2024 Accepting new patients
Telecare Corporation Past Accepting new patients

Locations

1396 W Herndon Ave
Fresno, CA 93711
Phone (559) 216-1997

1393 Bailey St
Hanford, CA 93230
Phone (559) 582-4481

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1629253836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11800",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937751800",
            "telephone_number": "559-453-6599",
            "fax_number": "559-453-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E KINGS CANYON RD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-453-6599",
            "fax_number": "559-453-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHBAZIAN",
        "first_name": "RANDALL",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A85058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.