Provider Demographics
NPI:1295839934
Name:MAJID SHAHBAZ MD INC
Entity Type:Organization
Organization Name:MAJID SHAHBAZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHBAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-583-1174
Mailing Address - Street 1:5555 RESERVOIR DRIVE SUITE 312
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120
Mailing Address - Country:US
Mailing Address - Phone:619-583-1174
Mailing Address - Fax:619-583-4609
Practice Address - Street 1:5555 RESERVOIR DR
Practice Address - Street 2:# 312
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5134
Practice Address - Country:US
Practice Address - Phone:619-583-1174
Practice Address - Fax:619-583-4609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A504020Medicaid
CA00A504020Medicaid
F50703Medicare UPIN