Individual provider Active NPI

Shahid Hussain Sial, M.D.

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1750381844
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A49659 Issued in CA
Practice address
1245 Wilshire Blvd
Ste 616
Los Angeles, CA 90017-4806
Phone
(310) 400-4189
Fax
(310) 347-4246
NPI assigned
Jul 29, 2005
Last updated
Nov 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A49659 CA Primary

Addresses

Primary practice location

1245 Wilshire Blvd
Ste 616
Los Angeles, CA 90017-4806

Mailing address

1245 Wilshire Blvd
Ste 616
Los Angeles, CA 90017-4806
Phone (310) 400-4189

Other identifiers 3

IdentifierTypeStateIssuer
00A496590OtherCABLUE SHIELD PIN
00A496590MedicaidCA
562426145OtherCATAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A49659CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Past Accepting new patients
Thomas H Kanegae M D a Medical Corporation PastSince Jan 2, 2004 Accepting new patients

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1750381844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "STE 616",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174806",
            "telephone_number": "310-400-4189",
            "fax_number": "310-347-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 WILSHIRE BLVD",
            "address_2": "STE 616",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900174806",
            "telephone_number": "310-400-4189",
            "fax_number": "310-347-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAL",
        "first_name": "SHAHID",
        "middle_name": "HUSSAIN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A49659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "00A496590",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A496590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "562426145",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.