Mir J Shadjareh, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

22848 Issued in CA

Practice address

62 Corporate Park
145
Irvine, CA 92606-3122

Phone

(949) 333-2224

Fax

(949) 333-2225

NPI assigned

Jul 17, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1851590947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14252 CULVER DR",
            "address_2": "A198",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040317",
            "telephone_number": "714-655-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK",
            "address_2": "145",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063122",
            "telephone_number": "949-333-2224",
            "fax_number": "949-333-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADJAREH",
        "first_name": "MIR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "22848",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "22848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Irvine, CA
• Providers in Irvine, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.