Active NPI
Southern California Infectious Disease Physicians Medical Group Inc
- Infectious Disease Physician
- La Puente, CA
National Provider Identifier
1114347507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- SOUTHERN CALIFORNIA INFECTIOUS DISEASE PHYSICIANS MEDICAL GROUP INC
- Practice address
- 18335 E Valley Blvd
La Puente, CA 91744-5968 - Phone
- (626) 810-3330
- Fax
- (626) 964-0440
- NPI assigned
- Apr 24, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Beena H Shah, MD
- Title
- President
- Phone
- (626) 810-3330
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | Primary |
Addresses
Primary practice location
18335 E Valley Blvd
La Puente, CA 91744-5968
Mailing address
18335 E Valley Blvd
La Puente, CA 91744-5968
Phone (626) 810-3330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Infectious Disease Physician
- Yorba Linda, CA
- NPI 1790795953
-
- Infectious Disease Physician
- Anaheim, CA
- NPI 1730243759
-
- Infectious Disease Physician
- Northridge, CA
- NPI 1881874691
-
- Infectious Disease Physician
- San Diego, CA
- NPI 1568624336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1398297600000",
"number": "1114347507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18335 E VALLEY BLVD",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917445968",
"telephone_number": "626-810-3330",
"fax_number": "626-964-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18335 E VALLEY BLVD",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917445968",
"telephone_number": "626-810-3330",
"fax_number": "626-964-0440"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN CALIFORNIA INFECTIOUS DISEASE PHYSICIANS MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-24",
"last_updated": "2014-04-24",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "BEENA",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "626-810-3330",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.