Shabana Moin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A79703 Issued in CA

Practice address

255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861

Phone

(559) 297-1300

Fax

(559) 324-7534

NPI assigned

Jul 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

• Primary Care Consultants, Inc. a Medical Group

  • Family Medicine Physician
  • Clovis, CA
  • NPI 1659303832
  NPD (past)
• Reedley Community Hospital

  • Rural Health Clinic/Center
  • Earlimart, CA
  • NPI 1821699620
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861425209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE",
            "address_2": "SUITE 124",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-297-1300",
            "fax_number": "559-324-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE",
            "address_2": "SUITE 124",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-297-1300",
            "fax_number": "559-324-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOIN",
        "first_name": "SHABANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A79703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Axiro LLC
• Nicholas Daniel Moes
• Michael John Moffett, M.D.
• Harjoyt Mohar, PHARM. D
• Ariana Mohayaee, PHARMD
• George C Molina, M.D.
• Rocio Anayely Molina
• Gisela Erica Mondragon
• Shirley Mondragon
• Ayanna Montalvo

• Family Medicine Physician in Clovis, CA
• Providers in Clovis, 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 Jul 8, 2007; 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.