Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shadi Rashtak, MD

Individual provider Dermatology Physician · NPI 1053546416

Shadi Rashtak, MD is a Dermatology in Vallejo, California. Qualified in 2003, 23 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California, Kentucky, Minnesota and Ohio.

Years since qualifying
23
Licensed in
CA, KY, MN, OH
In the registry since
2009
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

975 Sereno Dr
Vallejo, CA 94589-2441
Phone: (707) 651-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence A149698 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence 47222 (KY)
Dermatology Physician Taxonomy 207N00000X · Licence 54232 (MN)
Dermatology Physician Taxonomy 207N00000X · Licence V149698 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence 35123652 (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053546416
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 28, 2009
Last updated in NPPESFebruary 2, 2022
Certification dateFebruary 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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