Organization Active NPI

Shawn Crum, D.O., M.P.H. a Medical Corporation

  • Infectious Disease Physician
  • Huntington Beach, CA
National Provider Identifier
1326495250
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
20A12244 Issued in CA
Legal business name
SHAWN CRUM, D.O., M.P.H. A MEDICAL CORPORATION
Practice address
16787 Beach Blvd
#337
Huntington Beach, CA 92647-4848
Phone
(714) 903-7767
Fax
(714) 903-7801
NPI assigned
May 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

Name
Dr. Shawn Crum, D.O., M.P.H.NPI 1295018984
Title
President
Phone
(714) 698-9042

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
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 20A12244 CA Primary

Addresses

Primary practice location

16787 Beach Blvd
#337
Huntington Beach, CA 92647-4848

Mailing address

16787 Beach Blvd
#337
Huntington Beach, CA 92647-4848
Phone (714) 903-7767

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160926000590 CA Part B Supplier - Clinic/Group Practice 0840586673 Receives reassigned benefits from 1 practitioner
Practice locations: Los Alamitos, CA; Westminster, CA; Huntington Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1326495250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16787 BEACH BLVD",
            "address_2": "#337",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474848",
            "telephone_number": "714-903-7767",
            "fax_number": "714-903-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16787 BEACH BLVD",
            "address_2": "#337",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474848",
            "telephone_number": "714-903-7767",
            "fax_number": "714-903-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN CRUM, D.O., M.P.H. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-698-9042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., M.P.H."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "20A12244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.