Individual provider Active NPI

Gene Victor Sherman, MD

  • Hematology & Oncology Physician
  • El Segundo, CA
National Provider Identifier
1073576310
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
G36480 Issued in CA
Practice address
615 N Nash St
Suite 203
El Segundo, CA 90245-2825
Phone
(310) 568-9595
Fax
(310) 568-9595
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G36480 CA Primary

Addresses

Primary practice location

615 N Nash St
Suite 203
El Segundo, CA 90245-2825

Mailing address

PO Box 2609
Palos Verdes Peninsula, CA 90274-8609
Phone (310) 568-9595

Other identifiers 1

IdentifierTypeStateIssuer
00G364800MedicaidCA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G36480CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Physicians Medical Group, Inc. PastSince Jun 27, 1996 Accepting new patients
Gene V. Sherman, M.D., Inc. Hematology & Oncology PastSince Jun 30, 2003 Accepting new patients

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1073576310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2609",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902748609",
            "telephone_number": "310-568-9595",
            "fax_number": "310-568-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N NASH ST",
            "address_2": "SUITE 203",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452825",
            "telephone_number": "310-568-9595",
            "fax_number": "310-568-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "GENE",
        "middle_name": "VICTOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G36480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G364800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.