NPIMap

Organization Active NPI

Shahla P Rahmatullah M.D. Inc

  • Medical Specialty Clinic/Center
  • Irvine, CA
National Provider Identifier
1922296854
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
00C519930 Issued in CA
Legal business name
SHAHLA P RAHMATULLAH M.D. INC
Practice address
4870 Barranca Pkwy Ste 230
Irvine, CA 92604-4788
Phone
(949) 653-1300
Fax
(949) 653-1311
NPI assigned
Oct 4, 2007
Last updated
Dec 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Ms. Shahla P Rahmatullah, MD
Title
Provider
Phone
(949) 653-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 00C519930 CA Primary

Addresses

Primary practice location

4870 Barranca Pkwy Ste 230
Irvine, CA 92604-4788

Mailing address

351 Old Newport Blvd
Suite 212
Newport Beach, CA 92663-4120
Phone (949) 653-1300

Other identifiers 1

IdentifierTypeStateIssuer
00C519930MedicaidCA

National Provider Directory

National Provider Directory

Locations

113 Waterworks Way
Ste 340
Irvine, CA 92618
Phone (949) 650-6700

451 E Almond Ave
Ste 103
Madera, CA 93637
Phone (559) 673-4000

351 Old Newport Blvd
Ste 212
Newport Beach, CA 92663

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1922296854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 OLD NEWPORT BLVD",
            "address_2": "SUITE 212",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634120",
            "telephone_number": "949-653-1300",
            "fax_number": "949-353-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 BARRANCA PKWY STE 230",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044788",
            "telephone_number": "949-653-1300",
            "fax_number": "949-653-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHLA P RAHMATULLAH M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "RAHMATULLAH",
        "authorized_official_first_name": "SHAHLA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "949-653-1300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "00C519930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C519930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.