Organization Active NPI

Archana Shende M D Inc

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1053515825
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A50235 Issued in CA
Legal business name
ARCHANA SHENDE M D INC
Practice address
1211 W la Palma Ave
309
Anaheim, CA 92801-2815
Phone
(714) 999-1050
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Archana C Shende, M DNPI 1043255938
Title
Ceo
Phone
(714) 999-1050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A50235 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave
309
Anaheim, CA 92801-2815

Mailing address

1211 W la Palma Ave
309
Anaheim, CA 92801-2815
Phone (714) 999-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050701000900 CA Part B Supplier - Clinic/Group Practice 9032155783 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

1211 W La Palma Ave
Ste 309
Anaheim, CA 92801
Phone (714) 951-1910

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1053515825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "309",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-999-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE",
            "address_2": "309",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012815",
            "telephone_number": "714-999-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHANA SHENDE M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "SHENDE",
        "authorized_official_first_name": "ARCHANA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-999-1050",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50235",
            "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 Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.