| Dr Stephen Faraz Shafizadeh, MD PHD DC | |
|
400 N Pepper Ave Ste 308, Colton, CA 92324-1819 | |
| (909) 580-1366 | |
| (909) 580-1363 |
| Full Name | Dr Stephen Faraz Shafizadeh |
|---|---|
| Gender | Male |
| Speciality | Neurosurgery |
| Experience | 20 Years |
| Location | 400 N Pepper Ave Ste 308, Colton, California |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508177114 | NPI | - | NPPES |
| 192487001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | 125050087 (Illinois) | Secondary |
| 207T00000X | Neurological Surgery | A125298 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eisenhower Medical Center | Rancho mirage, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cal Med Physicians And Surgeons Inc | 4385556687 | 27 |
| Eisenhower Medical Center | 5890689657 | 401 |
| Arrowhead Neurosurgical Medical Group Inc | 7315900644 | 12 |
| Entity Name | Cal Med Physicians And Surgeons Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316054737 PECOS PAC ID: 4385556687 Enrollment ID: O20031104000708 |
| Entity Name | Arrowhead Neurosurgical Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639255854 PECOS PAC ID: 7315900644 Enrollment ID: O20041108001131 |
| Entity Name | Eisenhower Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013981554 PECOS PAC ID: 5890689657 Enrollment ID: O20100506000102 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Stephen Faraz Shafizadeh, MD PHD DC 3400 S Bowman Rd Apt 1723, Little Rock, AR 72211-4655 Ph: (773) 440-0801 | Dr Stephen Faraz Shafizadeh, MD PHD DC 400 N Pepper Ave Ste 308, Colton, CA 92324-1819 Ph: (909) 580-1366 |
Javed Siddiqi, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Armc Modular#3, Colton, CA 92324 Phone: 909-580-6210 Fax: 909-580-1363 | |
Sarah Kay Burke, Neurological Surgery Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-1000 | |
Deependra Mahato, DO Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-3353 | |
Dr. Vivek Ramakrishnan, DO Neurological Surgery Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave, Dept. Neurosurgery Mod# 3, Colton, CA 92324 Phone: 909-580-3353 Fax: 909-580-1363 | |
Dan Miulli, DO Neurological Surgery Medicare: May Accept Medicare Assignments Practice Location: 400 N Pepper Ave, Dept. Surgery Modular # 3, Colton, CA 92324 Phone: 909-580-3353 Fax: 909-580-1363 | |
Margaret Wacker, MD Neurological Surgery Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave, Armc, Colton, CA 92324 Phone: 909-580-6210 Fax: 909-580-1363 |