Individual provider Active NPI

Shewak Ram Lund, MD

  • Family Medicine Physician
  • Arcadia, CA
National Provider Identifier
1336244458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A38222 Issued in CA
Practice address
624 W Duarte Rd
Suite#103
Arcadia, CA 91007-7603
Phone
(626) 294-2070
Fax
(626) 294-2076
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A38222 CA Primary

Addresses

Primary practice location

624 W Duarte Rd
Suite#103
Arcadia, CA 91007-7603

Mailing address

16756 Knollwood Dr
Granada Hills, CA 91344-2625
Phone (626) 294-2070

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006001202 CA Practitioner - General PracticePractitioner - Family Practice 9739148644 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38222CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Mar 19, 2020 Accepting new patients

Locations

15206 Parthenia St
Sepulveda, CA 91343

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336244458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16756 KNOLLWOOD DR",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442625",
            "telephone_number": "626-294-2070",
            "fax_number": "626-294-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD",
            "address_2": "SUITE#103",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910077603",
            "telephone_number": "626-294-2070",
            "fax_number": "626-294-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUND",
        "first_name": "SHEWAK",
        "middle_name": "RAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.