Vitaliy Shaulov, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A77592 Issued in CA

Practice address

25411 Cabot Rd
Suite 116
Laguna Hills, CA 92653-5520

Phone

(949) 309-7903

Fax

(949) 716-5243

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Psychiatry a Medical CorporationGroup PAC ID 4587057286, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Integrative Psychiatry a Medical Corporation

  • Psychiatry Physician
  • Laguna Niguel, CA
  • NPI 1720268980
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1699705590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28895 EL APAJO",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777616",
            "telephone_number": "949-309-7903",
            "fax_number": "949-716-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25411 CABOT RD",
            "address_2": "SUITE 116",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535520",
            "telephone_number": "949-309-7903",
            "fax_number": "949-716-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAULOV",
        "first_name": "VITALIY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A77592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kareem Dan Sharaf, PA
• Amin Sharif, PA-C
• Priya Sharma
• Rahul Sharma, D.O.
• Leslie Shatner Walker
• Sheida Shavalian
• Diane Shaw
• Sheila Lanham Enterprises, Inc.
• Heather Shelby
• Michael W Shen, MD

• Psychiatry Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.