SHALA RAHBAR FARDIN (MD) – Dermatology Physician, NPI 1720114432

SHALA RAHBAR FARDIN (MD) is a healthcare provider. based in Sausalito, California. specializing in Dermatology Physician. They hold the professional credentials MD. They hold a License No. P-230971 (MA). The NPI Number for SHALA RAHBAR FARDIN (MD) is 1720114432

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
SHALA RAHBAR FARDIN (MD)
NPI
1720114432
Phone
(415) 887-9758
Address
2330 MARINSHIP WAY STE 370
Enumeration Date
26 February 2007
Last Update Date
24 September 2013

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
4158879758
Graduation Year
2003 (23 years ago)
PAC ID
6800978164
Group Practice PAC ID
2668614447
Professional Enrollment ID
I20090715000698
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

Provider Addresses for SHALA RAHBAR FARDIN (MD)

  • 2330 MARINSHIP WAY STE 370

    SAUSALITO, CA 949652853

    Phone: (415) 887-9758

    Fax: (415) 887-9763

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $195.

Total Amount is formed as General ($195) + Research ($0) + Ownership ($0) = $195.

Last reported payment date: 2023-09-26 • Largest payer in this snapshot: PFIZER INC. ($124).

Total Amount

$195

General + Research + Ownership

Payments

4

Total payment records

General Amount

$195

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090715000698IDermatologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94965)

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Provider's Procedures

SHALA RAHBAR FARDIN (MD) performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYCA11101Biopsy of each additional growth of skin and/or tissue1915
DERMATOLOGYCA17003Destruction of 2-14 skin growths26055

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668614447View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
Physician AssistantCA
Physician AssistantCA
-CA
Physician AssistantCA
D E R M A T O L O G YCA
D E R M A T O L O G YNJ

Reviews

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Frequently asked questions

Is SHALA RAHBAR FARDIN (MD) listed with a National Provider Identifier?
Yes — SHALA RAHBAR FARDIN (MD) has NPI 1720114432 on file in the registry.
Active or inactive — what applies to SHALA RAHBAR FARDIN (MD)?
You should see SHALA RAHBAR FARDIN (MD) as active in CMS-hosted NPPES data.
What clinical focus is listed for SHALA RAHBAR FARDIN (MD)?
At a glance, SHALA RAHBAR FARDIN (MD) is tied to Dermatology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for SHALA RAHBAR FARDIN (MD)?
Travel planning: use Sausalito, California as the reference point for SHALA RAHBAR FARDIN (MD), then confirm.
Can I trust this NPI listing for SHALA RAHBAR FARDIN (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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