Shahab Momtazi, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

G68758 Issued in CA

Practice address

202 W Willow
# 305
Visalia, CA 93291

Phone

(559) 732-0762

Fax

(559) 627-5192

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1679648117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4199",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93278",
            "telephone_number": "559-627-6363",
            "fax_number": "559-627-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W WILLOW",
            "address_2": "# 305",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "559-732-0762",
            "fax_number": "559-627-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMTAZI",
        "first_name": "SHAHAB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G68758",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G68758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G687580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yuritsi Araceli Mojica
• Katie M Molano, LMFT
• Estherose Molina
• Lorene Molina
• Tania Molina
• Monarch Obstetrics Management Services, Inc
• Claudia Lorena Moncada, DDS
• Alyssa Rivera Moncibaiz, LCSW
• Nabori Rebecca Monclova, LMFT
• Kimia Yeganegi Mondegari, MD

• Pulmonary Disease Physician in Visalia, CA
• Providers in Visalia, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.