Alan L. Shabo M.D. a Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A23893 Issued in CA

Legal business name

ALAN L. SHABO M.D. A MEDICAL CORPORATION

Practice address

10921 Wilshire Blvd
Suite 1205
Los Angeles, CA 90024-3906

Phone

(310) 824-9661

Fax

(310) 824-9867

NPI assigned

Mar 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alan Louis Shabo, M.D.NPI 1073730081

Title

Physician&Surgeon/Ophthalmologist

Phone

(310) 824-9661

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Alan Louis Shabo, M.D.

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1073730081
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1295000693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD",
            "address_2": "SUITE 1205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243906",
            "telephone_number": "310-824-9661",
            "fax_number": "310-824-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD",
            "address_2": "SUITE 1205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243906",
            "telephone_number": "310-824-9661",
            "fax_number": "310-824-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN L. SHABO M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "SHABO",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PHYSICIAN&SURGEON/OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "310-824-9661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A23893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "A23893",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "01112710004286-001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.