Irwin Shelub, M.D.

Individual provider Active NPI Pulmonary Disease Physician · Creston, CA

NPI 1104855246 · NPPES record last updated Jan 5, 2017

Key facts

NPI
1104855246
Entity type
Individual (NPI type 1)
Primary specialty
Pulmonary Disease Physician 207RP1001X
License
C36888 (CA)
Practice address
4975 Iron Springs Rd
Creston, CA 93432-9794
Phone
(650) 520-0635
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C36888CAMDPulmonary Disease Physician
36888CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Pulmonary Pulmonary Disease Current Accepting new patients
Palo Alto Medical Foundation Past Accepting new patients
Cogent Healthcare of Daly City, P.C. Past Accepting new patients
Daly City Hospitalist Group, Inc. Past
since May 1, 2010
Accepting new patients

Locations

1900 Sullivan Ave
#813
Daly City, CA 94015
Phone (650) 991-6380

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

901 Campus Dr
Ste 306
Daly City, CA 94015
Phone (415) 991-0600

901 Campus Dr
Ste 308
Daly City, CA 94015
Phone (650) 991-0600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X C36888 CA Yes

Addresses

Primary practice location

4975 Iron Springs Rd
Creston, CA 93432-9794

Mailing address

4975 Iron Springs Rd
Creston, CA 93432-9794
Phone (650) 520-0635

Sources for this page

Verify at the official NPI Registry.