Organization Active NPI

David Shek M.D.,Inc.

  • Primary Care Clinic/Center
  • Anaheim, CA
National Provider Identifier
1245319631
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A30945 Issued in CA
Legal business name
DAVID SHEK M.D.,INC.
Practice address
1401 S Anaheim Blvd
Anaheim, CA 92805-6214
Phone
(714) 772-9800
Fax
(714) 772-6800
NPI assigned
Nov 4, 2006
Last updated
Jun 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Authorized official

Name
Dr. David Shek, M.D.NPI 1346289915
Title
President
Phone
(714) 772-9800

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)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A30945 CA Primary

Addresses

Primary practice location

1401 S Anaheim Blvd
Anaheim, CA 92805-6214

Mailing address

1401 S Anaheim Blvd
Anaheim, CA 92805-6214
Phone (714) 772-9800

Other identifiers 3

IdentifierTypeStateIssuer
1346289915OtherCANPI FOR DAVID SHEK M.D.
1245319631OtherCANPI FOR DAVID SHEK MD INC
00A309450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000286 CA Part B Supplier - Clinic/Group Practice 0345324356 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA; Hawaiian Gardens, CA; Brea, CA

National Provider Directory

National Provider Directory

Locations

239 N Brea Blvd
Brea, CA 92821
Phone (714) 671-0060

11803 Carson St
Hawaiian Gdns, CA 90716
Phone (562) 924-4455

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1245319631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056214",
            "telephone_number": "714-772-9800",
            "fax_number": "714-772-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S ANAHEIM BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056214",
            "telephone_number": "714-772-9800",
            "fax_number": "714-772-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID SHEK M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-04",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "SHEK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-772-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A30945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DAVID SHEK M.D.",
            "identifier": "1346289915",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR DAVID SHEK MD INC",
            "identifier": "1245319631",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A309450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.