Active NPI
Kamal Ezoury Shamash, MD
- Family Medicine Physician
- Daly City, CA
National Provider Identifier
1295819969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A30183
- Practice address
- 901 Campus Drive
112
Daly City, CA 94015 - Phone
- (650) 991-1842
- Fax
- (650) 991-3367
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A30183 | CA | Primary |
Addresses
Primary practice location
901 Campus Drive
112
Daly City, CA 94015
Mailing address
901 Campus Drive
Suite 112
Daly City, CA 94015
Phone (650) 991-1842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A301830 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCHS Medical Foundation | Family Medicine | Current | Accepting new patients |
| Verity Medical Foundation | Current | Accepting new patients | |
| Palo Alto Medical Foundation | Past | Accepting new patients |
Locations
901 Campus Dr
Ste 214
Daly City, CA 94015
Phone (415) 785-4246
25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- San Jose, CA
- NPI 1326312067
-
- Non-Pharmacy Dispensing Site
- Santa Cruz, CA
- NPI 1114182649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1295819969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 CAMPUS DRIVE",
"address_2": "SUITE 112",
"city": "DALY CITY",
"state": "CA",
"postal_code": "94015",
"telephone_number": "650-991-1842",
"fax_number": "650-991-3367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 CAMPUS DRIVE",
"address_2": "112",
"city": "DALY CITY",
"state": "CA",
"postal_code": "94015",
"telephone_number": "650-991-1842",
"fax_number": "650-991-3367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAMASH",
"first_name": "KAMAL",
"middle_name": "EZOURY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A30183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A301830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daly City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.