Tony K Shum, M.D. Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G40567 Issued in CA

Legal business name

TONY K SHUM, M.D. INC

Practice address

889 S San Gabriel Blvd
San Gabriel, CA 91776-2724

Phone

(626) 285-0800

Fax

(626) 285-0830

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Tony K Shum, M.D.NPI 1740228998

Title

Owner

Phone

(626) 285-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DSC Laser & Skin Care Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tony K Shum, M.D.

  • Otolaryngology Physician
  • San Gabriel, CA
  • NPI 1740228998
  NPD (past) Authorized official
• Hazel NG, R.D.

  • Registered Dietitian
  • San Gabriel, CA
  • NPI 1750321634
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043258171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762724",
            "telephone_number": "626-285-0800",
            "fax_number": "626-285-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762724",
            "telephone_number": "626-285-0800",
            "fax_number": "626-285-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY K SHUM, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUM",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-285-0800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G40567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G405671",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DSC Laser & Skin Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Otolaryngology Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.