Provider Demographics
NPI:1992000152
Name:ONG RUBIN SHAHMIR A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ONG RUBIN SHAHMIR A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PRACTICE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHMIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-446-4379
Mailing Address - Street 1:1411 OLIVER RD STE 250
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3425
Mailing Address - Country:US
Mailing Address - Phone:707-446-4379
Mailing Address - Fax:707-446-4417
Practice Address - Street 1:1411 OLIVER RD STE 250
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3425
Practice Address - Country:US
Practice Address - Phone:707-446-4379
Practice Address - Fax:707-446-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty