SHADI RASHTAK (NPI# 1053546416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053546416 |
| Entity Type | Individual |
| Full Name | SHADI RASHTAK |
| Credential | MD |
| Practice Address |
975 Sereno Dr Vallejo CA 94589-2441 |
| Mailing Address |
68 Cavalier Blvd Florence KY 41042-1645 |
| Practice Telephone | 7076511000 |
| Mailing Telephone | (513) 475-7630 |
| Mailing Fax Number | 8597818374 |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2017-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | V149698 | CA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | A149698 | CA | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 47222 | KY | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 35123652 | OH | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 54232 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
975 SERENO DR |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940620 | James A Carolan | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2005-05-31 |
| 1386243483 | Chrismichael C Caniaveral | Pulmonary Function Technologist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-10-20 |
| 1598376188 | Justin Parungao Vallarta | Pharmacist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-08-16 |
| 1083232524 | Jeremy Cobb Mutter | Respiratory Therapist, Certified | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-07-10 |
| 1083230361 | Rabeea Abbas | Orthopaedic Surgery | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-06-22 |
| 1518588490 | Claudia S Vanover | Radiology | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-05-01 |
| 1013536937 | Nicole Anne Madrilejo | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-10 |
| 1457970527 | Sean N Ryan | Physical Therapist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-09 |
| 1528687787 | Natalie Sukie White | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-08 |
| 1801423223 | Jacqueline Yu | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003227372 | Jonathan Okman | Dermatology | 2290 Sacramento St, Vallejo, CA 94590 | 2014-05-08 |
| 1821238569 | Meghan Elizabeth Kennedy | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2009-02-20 |
| 1811159387 | Kathryn Marie Kent | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2008-06-26 |
| 1750564407 | Joshua Paul Spanogle | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2007-12-17 |
| 1780758086 | Paradi Mirmirani | Dermatology | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2006-11-20 |
| 1437237245 | Eileen Crowley | Dermatology | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2006-11-01 |
| 1679651483 | Robin St. Clair Gray | Dermatology | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2006-11-01 |
| 1275571028 | John Kevin Geisse | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2006-06-03 |
| 1518911395 | Serena Mraz | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2006-05-19 |
| 1922052729 | Solano Dermatology Associates Inc | Dermatology | 2290 Sacramento St, Vallejo, CA 94590-2929 | 2006-05-19 |
| Find all providers in VALLEJO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.