Fariba Shoja-Taheri, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

63130 Issued in GA

Practice address

25455 Barton Rd Ste 209B
Loma Linda, CA 92354-3133

Phone

(909) 558-6688

Fax

(909) 558-6656

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Loma Linda Inland Consortium for Healthcare Education

  • Clinic/Center
  • Loma Linda, CA
  • NPI 1033554613
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1770790784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 RIVERSTONE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309079291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD STE 209B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543133",
            "telephone_number": "909-558-6688",
            "fax_number": "909-558-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOJA-TAHERI",
        "first_name": "FARIBA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "63130",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "63130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sang Gyu Shin
• Emilia Shinne, PH.D.
• Rod Shinozaki, M.D.
• Preston Andrew Shirsat
• Celeste Shoeleh, MD
• Shokry Lawandy, DO
• Anthony Eli Shoo, M.D.
• James E Shook, M.D.
• Abdulwhab Shremo Msdi
• Puneeth Shridhar, MD PHD

• Family Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.