Pacific Shores Medical Group, Inc.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

PACIFIC SHORES MEDICAL GROUP, INC.

Practice address

3747 Worsham Ave
Ste 101
Long Beach, CA 90808-1774

Phone

(562) 430-5900

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Nerses Simon Tchekmedyian, M.D.NPI 1821032129

Title

Ceo

Phone

(562) 590-0345

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• City of Hope Medical Foundation

  • Hematology & Oncology Physician
  • Long Beach, CA
  • NPI 1417968413

  O20040417000523

  Same enrollment
• Pacific Shores Medical Group, Inc

  • Hematology & Oncology Physician
  • Irvine, CA
  • NPI 1447587050

  O20040417000523

  Same enrollment
• Pacific Shores Medical Group, Inc

  • Hematology & Oncology Physician
  • Huntington Beach, CA
  • NPI 1598814634

  O20040417000523

  Same enrollment
• Pacific Shores Medical Group, Inc.

  • Hematology & Oncology Physician
  • Monterey Park, CA
  • NPI 1639375132

  O20040417000523

  Same enrollment
• Pacific Shores Medical Group, Inc.

  • Hematology & Oncology Physician
  • Glendale, CA
  • NPI 1871642991

  O20040417000523

  Same enrollment

Locations

Practitioners 4

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

• Nerses Simon Tchekmedyian, M.D.

  • Hematology & Oncology Physician
  • Irvine, CA
  • NPI 1821032129
  NPD Authorized official
• Rose-Ann Guevarra

  • Physician Assistant
  • Fullerton, CA
  • NPI 1154889327
  NPD
• Anna Kalmanovich, RPA-C

  • Physician Assistant
  • Long Beach, CA
  • NPI 1831259910
  NPD
• Karen Anne Shadrick

  • Nurse Practitioner
  • Costa Mesa, CA
  • NPI 1205322872
  NPD

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1073662110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 ELM AVE",
            "address_2": "STE 104",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133271",
            "telephone_number": "562-590-0345",
            "fax_number": "562-437-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 WORSHAM AVE",
            "address_2": "STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081774",
            "telephone_number": "562-430-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SHORES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "TCHEKMEDYIAN",
        "authorized_official_first_name": "NERSES",
        "authorized_official_middle_name": "SIMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-590-0345",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065543",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Palms Healthcare, LLC
• Pacific Plaza Pharmacy,Inc.
• Pacific Psych Solutions Inc
• Pacific Rejuvination Medical a Professional Corp
• Pacific Resources Psychological Group
• Pacific Speech Therapy, Inc
• Pacific Villa, Inc.
• Pacific Wellness Center Chiropractic, Iseke Beltran Inc
• Pacific Wellness Clinic Iseke Beltran Inc.
• Serena Pack

• Hematology & Oncology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Hematology & Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.