Brit S Shackley MD Apc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A107373 Issued in CA

Legal business name

BRIT S SHACKLEY MD APC

Practice address

100 W California Blvd
Pasadena, CA 91105-3010

Phone

(626) 397-5667

Fax

(626) 397-2156

NPI assigned

Aug 15, 2012

Last updated

Aug 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brit Shackley, MDNPI 1336460435

Title

President

Phone

(626) 397-5667

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Brit S Shackley, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pasadena, CA
  • NPI 1336460435
  Authorized official Same address or phone

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1336497759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5667",
            "fax_number": "626-397-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5667",
            "fax_number": "626-397-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIT S SHACKLEY MD APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "SHACKLEY",
        "authorized_official_first_name": "BRIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-397-5667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A107373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MED LICENSE",
            "identifier": "A107373",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Brinkerhoff
• Louis Briones, MD
• Monique Briones
• Niomi M Briones
• Alexandra Bristow
• Natalie Nicole Brito
• Jeanette Brizuela
• Hideko Brnak, IBCLC
• Robyn Broadus, LMFT
• Annessa Leeann Brock, BCBA

• Anatomic Pathology & Clinical Pathology Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.