Individual provider Active NPI

Nancy Shenouda, PA

  • Medical Physician Assistant
  • South Gate, CA
National Provider Identifier
1427290980
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15758 Issued in CA
Practice address
10132 California Ave
South Gate, CA 90280-6008
Phone
(323) 566-4411
NPI assigned
Mar 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA15758 CA Primary

Addresses

Primary practice location

10132 California Ave
South Gate, CA 90280-6008

Mailing address

10132 California Ave
South Gate, CA 90280-6008
Phone (323) 566-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1427290980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "323-566-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "323-566-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOUDA",
        "first_name": "NANCY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.