Active NPI
Shaun Adam Cruz, PA
- Physician Assistant
- Anaheim, CA
National Provider Identifier
1033827704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA61954
- Practice address
- 8170 E Morning Sun LN
Anaheim, CA 92808-2511 - Phone
- (714) 326-0881
- NPI assigned
- Nov 10, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA61954 | CA | Primary |
Addresses
Primary practice location
8170 E Morning Sun LN
Anaheim, CA 92808-2511
Mailing address
8170 E Morning Sun LN
Anaheim, CA 92808-2511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61954 | CA | MD | Pharmacist |
| PA61954 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1033827704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 E MORNING SUN LN",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928082511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8170 E MORNING SUN LN",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928082511",
"telephone_number": "714-326-0881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "SHAUN",
"middle_name": "ADAM",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-10",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA61954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.