Individual provider Active NPI

John K Shaib, MD

  • Nephrology Physician
  • Downey, CA
National Provider Identifier
1851339048
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G40205 Issued in CA
Practice address
9040 Telegraph Rd
Site 100
Downey, CA 90240-2393
Phone
(562) 861-0954
Fax
(562) 861-3739
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G40205 CA Primary

Addresses

Primary practice location

9040 Telegraph Rd
Site 100
Downey, CA 90240-2393

Mailing address

PO Box 486
Artesia, CA 90702-0486
Phone (562) 861-0954

Other identifiers 6

IdentifierTypeStateIssuer
110060907OtherRAILROAD
P00357366OtherRAILROAD
015521OtherHEALTH NET ID #
00G402050MedicaidCA
00G402051OtherCABLUE SHIELD #
00G402050OtherCABLUE SHIELD #

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
G40205CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caremore Medical Group Inc CurrentSince Mar 14, 2016 Accepting new patients
Rubin and McNamara MDS Inc Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Caremore Medical Group Nephrology Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

9040 Telegraph Rd
Downey, CA 90240
Phone (562) 861-0954

9040 Telegraph Rd
Ste 100
Downey, CA 90240
Phone (562) 861-0954

9040 Telegraph Rd
Ste 102
Downey, CA 90240
Phone (562) 861-0954

10000 Lakewood Blvd
Downey, CA 90240
Phone (562) 862-3684

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1851339048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907020486",
            "telephone_number": "562-861-0954",
            "fax_number": "562-861-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 TELEGRAPH RD",
            "address_2": "SITE 100",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902402393",
            "telephone_number": "562-861-0954",
            "fax_number": "562-861-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIB",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G40205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "110060907",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00357366",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET ID #",
            "identifier": "015521",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G402050",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "00G402051",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "00G402050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.