Shoreline Medical Group Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHORELINE MEDICAL GROUP PROFESSIONAL CORPORATION

Practice address

527 H St
Chula Vista, CA 91910-4301

Phone

(619) 709-7367

Fax

(619) 775-3170

NPI assigned

Aug 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Julie Roth, DONPI 1720091572

Title

Physician

Phone

(619) 804-2368

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Julie Anne Roth, DO

  • Family Medicine Physician
  • Chula Vista, CA
  • NPI 1720091572
  Medicare reassignment NPD Authorized official
• Leticia A. Polanco, M.D.

  • Family Medicine Physician
  • Chula Vista, CA
  • NPI 1710956818
  NPD (past)
• Tracy L. Polanco, M.D.

  • Family Medicine Physician
  • Chula Vista, CA
  • NPI 1538138631
  NPD (past)

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1225860232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104301",
            "telephone_number": "619-709-7367",
            "fax_number": "619-775-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104301",
            "telephone_number": "619-709-7367",
            "fax_number": "619-775-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE MEDICAL GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "619-804-2368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Shih
• Lynn Ann Shih, O.T.
• Alfred Shihata, M.D.
• Audrey Shinsky
• Tyrone Sholes
• Kate-Robin Shuart Piper, M.A.
• Lynnette Shugan, DMD
• Caleb Shumway, MD
• Aida Sias, RN
• Hilary Sibilia, NP

• Family Medicine Physician in Chula Vista, CA
• Providers in Chula Vista, 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 Jan 14, 2026; 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.