Shota Gurtch, M.D., Inc., a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHOTA GURTCH, M.D., INC., A PROFESSIONAL CORPORATION

Practice address

5565 Grossmont Center Dr
BLD 1 Ste 210
La Mesa, CA 91942-3020

Phone

(619) 461-3150

NPI assigned

Jun 2, 2014

Organization subpart

No

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

Authorized official

Name

Shota Gurtch, M.D.

Title

Physician Owner

Phone

(858) 997-3161

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1104238682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLD 1 STE 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-461-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLD 1 STE 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-461-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOTA GURTCH, M.D., INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "GURTCH",
        "authorized_official_first_name": "SHOTA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "858-997-3161",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Guillermo Shiroma, LMFT
• Ryan Shogan
• Richard Lee Short, M.D.
• Shota Gurtch, M.D., Inc. a Professional Corporation
• Shota Gurtch, M.D., Inc., a Professional Corporation
• Victoria G. Shuffelton, D.O.
• Bonnie Beth Shuman
• Manal Siddiq, MS, IMF
• Shabana Anjum Siddiqui, MD
• Andrew Jason Siegel, MS

• Family Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.