NPIMap

Individual provider Active NPI

David T. Shen, M.D.

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1235100330
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A063555 Issued in CA
Practice address
4910 Airport Plaza Dr Ste 100
Long Beach, CA 90815-1377
Phone
(562) 434-7777
Fax
(562) 433-3737
NPI assigned
Jan 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A063555 CA Primary

Addresses

Primary practice location

4910 Airport Plaza Dr Ste 100
Long Beach, CA 90815-1377

Mailing address

PO Box 828
Los Alamitos, CA 90720-0828
Phone (562) 434-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000886 CA Practitioner - Family Practice 0345330346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

3325 Palo Verde Ave
Long Beach, CA 90808-4132

3801 Katella Ave
Los Alamitos, CA 90720-3396

Hospital & facility affiliations

  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A063555CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Prohealth Partners a Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Careconnectmd Ca PC Family Medicine CurrentSince Jun 24, 2022 Accepting new patients
Magella Medical Group, Inc. Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

3325 Palo Verde Ave
Ste 105106
Long Beach, CA 90808
Phone (562) 344-7777

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1235100330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 828",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907200828",
            "telephone_number": "562-434-7777",
            "fax_number": "562-433-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 AIRPORT PLAZA DR STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151377",
            "telephone_number": "562-434-7777",
            "fax_number": "562-433-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "DAVID",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A063555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.