Bennett J Shiller, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G71120 Issued in CA

Practice address

6386 Alvarado CT
#310
San Diego, CA 92120-4905

Phone

(619) 229-5050

Fax

(619) 287-0833

NPI assigned

Nov 17, 2005

Last updated

Dec 13, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229126400000",
    "number": "1124000872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6386 ALVARADO CT",
            "address_2": "#310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204905",
            "telephone_number": "619-229-5050",
            "fax_number": "619-287-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6386 ALVARADO CT",
            "address_2": "#310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204905",
            "telephone_number": "619-229-5050",
            "fax_number": "619-287-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLER",
        "first_name": "BENNETT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G71120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G711200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patty C Shih, M.D.
• Robert Hsuan-Yang Shih, MD
• Vania Shih, P.T.
• William Hwa-Wei Shih, M.D.
• Chieko Shikata
• Jelisa Shillingford
• Jessica Shillito, D.P.T.
• Matthew Charles Shillito, M.D.
• Beatriz Shilts, OTR/L
• Bomy J Shim, DDS

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.