Organization Active NPI

Shafa Medical Center Inc

  • Primary Care Clinic/Center
  • Foothill Ranch, CA
National Provider Identifier
1750693560
Registry record updated Aug 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A101402 Issued in CA
Legal business name
SHAFA MEDICAL CENTER INC
Practice address
26730 Towne Centre Dr Ste 102
Foothill Ranch, CA 92610
Phone
(949) 559-5153
Fax
(949) 559-5252
NPI assigned
Jul 9, 2010
Last updated
Aug 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2023

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

Authorized official

Name
Hamid Eskandari, MDNPI 1063662682
Title
Owner
Phone
(949) 559-5153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A101402 CA Primary

Addresses

Primary practice location

26730 Towne Centre Dr Ste 102
Foothill Ranch, CA 92610

Mailing address

26730 Towne Centre Dr Ste 102
Foothill Ranch, CA 92610-2857
Phone (949) 559-5153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100730000333 CA Part B Supplier - Clinic/Group Practice 8921131723 Receives reassigned benefits from 4 practitioners
Practice locations: Foothill Ranch, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2155644Shafa Medical Center26730 Towne Centre Drive Suite 102, Foothill Ranch, CA 92610Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691884800000",
    "number": "1750693560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26730 TOWNE CENTRE DR STE 102",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926102857",
            "telephone_number": "949-559-5153",
            "fax_number": "949-559-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26730 TOWNE CENTRE DR STE 102",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "92610",
            "telephone_number": "949-559-5153",
            "fax_number": "949-559-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2023-08-13",
        "certification_date": "2023-08-13",
        "status": "A",
        "authorized_official_last_name": "ESKANDARI",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-559-5153",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A101402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foothill Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.