| Majid Shahbaz Md Inc | |
|
5555 Reservoir Dr # 312 San Diego CA 92120-5134 | |
| (619) 583-1174 | |
| (619) 583-4609 |
| Full Name | Majid Shahbaz Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5555 Reservoir Dr, San Diego, California |
| Authorized Official Name and Position | Majid Shahbaz (MEDICAL DOCTOR) |
| Authorized Official Contact | 6195831174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Majid Shahbaz Md Inc 5555 Reservoir Drive Suite 312 San Diego CA 92120 Ph: (619) 583-1174 | Majid Shahbaz Md Inc 5555 Reservoir Dr # 312 San Diego CA 92120-5134 Ph: (619) 583-1174 |
| NPI Number | 1295839934 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 12/10/2012 |
| Medicare PECOS PAC ID | 8224112628 |
|---|---|
| Medicare Enrollment ID | O20080225000153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295839934 | NPI | - | NPPES |
| 00A504020 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Majid Shahbaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790966018 PECOS PAC ID: 6406930809 Enrollment ID: I20080225000151 |
| Provider Name | Rhealynn S. Nofuente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902279599 PECOS PAC ID: 3274839519 Enrollment ID: I20160311001032 |
| Provider Name | Jandark Yuseif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114361284 PECOS PAC ID: 0244532224 Enrollment ID: I20161020001899 |
| Provider Name | Chelsea Provenzano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033631700 PECOS PAC ID: 6709144801 Enrollment ID: I20171219001744 |
| Provider Name | Kelly Ann Glas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790410033 PECOS PAC ID: 7911380217 Enrollment ID: I20220819000522 |
| Provider Name | Coral Roseberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255012860 PECOS PAC ID: 5799149217 Enrollment ID: I20230915001646 |
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