Individual provider Active NPI

Emma B Shak, M.D.

  • Student in an Organized Health Care Education/Training Program
  • San Francisco, CA
National Provider Identifier
1003259698
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
505 Parnassus Ave
San Francisco, CA 94143-1059
Phone
(415) 476-1528
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-1059

Mailing address

505 Parnassus Ave
San Francisco, CA 94143-1059
Phone (415) 476-1528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810002953 CA Practitioner - Internal Medicine 1759675945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
136440CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jun 1, 2016 Accepting new patients
Alameda Health System CurrentSince Jun 1, 2016 Accepting new patients

Locations

15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1003259698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941431059",
            "telephone_number": "415-476-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941431059",
            "telephone_number": "415-476-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAK",
        "first_name": "EMMA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.