Reza Shahba, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC36204 Issued in CA

Practice address

4132 Katella Ave Ste 102
Los Alamitos, CA 90720-3491

Phone

(562) 596-9677

Fax

(562) 795-6630

NPI assigned

Dec 14, 2021

Last updated

Nov 17, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shahba Body Revive Chiropractic Corporation

  dba Alamitos back pain center

  • Chiropractor
  • Los Alamitos, CA
  • NPI 1538889373
  NPD Authorized official

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1801555073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVE STE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203491",
            "telephone_number": "424-634-9373",
            "fax_number": "562-795-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVE STE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203491",
            "telephone_number": "562-596-9677",
            "fax_number": "562-795-6630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Paramount Blvd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902413324",
            "country_code": "US",
            "telephone_number": "424-634-9373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHBA",
        "first_name": "REZA",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36204",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC36204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Seiersen, RDE
• Michaelle Seiter, LCSW
• Donald N Serafano, MD
• Lauren Cady Sachdeva Shah, LCSW
• Shahba Body Revive Chiropractic Corporation (Alamitos back pain center)
• Adrian Harry Shandling, MD
• Lawrence A Shapiro, M.D.
• Shattuck Rehabilitation Services (Healing Hands Therapy & Wellness Center)
• Jeanette Louise Shattuck, OTR L
• Imad A Shbeeb, MD

• Chiropractor in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.