Nicky Shah, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A66655 Issued in CA

Practice address

12370 Hesperia Rd
Suite 15
Victorville, CA 92395-7719

Phone

(760) 261-5234

NPI assigned

Aug 30, 2010

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)
• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1881900629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD",
            "address_2": "SUITE 15",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957719",
            "telephone_number": "760-261-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NICKY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66655",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "40962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahrokh Shabahang, DDS,MS,PHD
• Adia Naki Shabazz-Regains
• Sarah Shabazz
• Montana M Shaffer, MA
• Bharati Shah, MD
• Sreya Shah, M.D.
• Laleh Shahriari
• Jay Eriah Shankar, MD
• Rashmi J Shankar, DDS
• Chitra Vijay Shanmugham

• Internal Medicine Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.