Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. SHADY FALTAOUS MD
NPI 1104627165
Radiology - Diagnostic Radiology in San Diego, CA

Q: What is Shady Faltaous's NPI number?

The NPI number for Shady Faltaous is 1104627165. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Q: What is Shady Faltaous's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Shady Faltaous was last updated on July 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 24, 2025

200 W ARBOR DR # MC8756, SAN DIEGO, CA 92103(858) 657-7000 Get Directions Write a Review

NPPES record last updated: July 26, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 26, 2026, Jul 6, 2026, Mar 24, 2025 (3 updates tracked since 2025).

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About Dr. Shady Faltaous Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHADY FALTAOUS MD (NPI 1104627165) is an individual diagnostic radiology provider in San Diego, California, licensed in California (A210658) and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1104627165

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. SHADY FALTAOUSCredential: MD

Location Address200 W ARBOR DR # MC8756San Diego, CA 92103-1911

Mailing Address200 W Arbor Dr # Mc8756San Diego, CA 92103-1911 · (858) 657-7000

Phone(858) 657-7000

Sole ProprietorNo

Enumeration DateMarch 24, 2025

Last NPPES UpdateJuly 26, 20263 updates tracked since enumeration

NPPES CertifiedJuly 26, 2026

✔ NPI 1104627165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in CA · A210658

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

200 W ARBOR DR # MC8756, San Diego, CA 92103

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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSAY MARIE BURROWES MD

Radiology (Diagnostic Radiology)