Individual provider Active NPI

Rongzi Shan, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1063049922
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A179945 Issued in CA
Practice address
2010 Zonal Ave Ste 4P1
Los Angeles, CA 90033-1026
Phone
(323) 409-1000
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A179945 CA Primary

Addresses

Primary practice location

2010 Zonal Ave Ste 4P1
Los Angeles, CA 90033-1026

Mailing address

1200 N State St
Los Angeles, CA 90089-1001
Phone (323) 409-1000

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
I20211227000069 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850782087

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1063049922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "323-409-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE STE 4P1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331026",
            "telephone_number": "323-409-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAN",
        "first_name": "RONGZI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A179945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.