Basic Information
| Provider Information | |||||||||
| NPI: | 1285879338 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHABBIR | ||||||||
| FirstName: | MUHAMMAD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | |||||||||
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| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3768 | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953443768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093833381 | ||||||||
| FaxNumber: | 2097222025 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 W EL PORTAL DR | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953482853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093833381 | ||||||||
| FaxNumber: | 2097222025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2008 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A106193 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | CS1342 | 01 | CA | MEDICARE RAILROAD CARRIER - GROUP PTAN | OTHER | 1285623256 | 01 | CA | MEDICARE RAILROAD CARRIER - GROUP NPI | OTHER | P00781388 | 01 | CA | MEDICARE RAILROAD CARRIER - GROUP MEMBER PTAN | OTHER | 1285879338 | 01 | CA | MEDICARE RAILROAD CARRIER - GROUP MEMBER NPI | OTHER |