Shore MDS Medical Corp

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A123437 Issued in CA

Legal business name

SHORE MDS MEDICAL CORP

Practice address

6801 Park Ter
Los Angeles, CA 90045-1543

Phone

(310) 665-7150

NPI assigned

Apr 12, 2013

Last updated

Nov 21, 2013By 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

Amy W Shore, M.D.NPI 1235305566

Title

President

Phone

(310) 792-3914

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Amy Wall Shore, M.D.

  • Anesthesiology Physician
  • Marina del Rey, CA
  • NPI 1235305566
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1427491018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-883-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "310-665-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE MDS MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-792-3914",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A123437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Shon
• Chan S Shon, M.D.
• Phillip Mankeun Shon, L.AC
• Thomas Lee Shook, M.D.
• Keith Patrick Shopa, MD
• Cody Shore
• Ma. Teresita Borio Shore, PTA
• Madeleine Shore
• Alison Short
• Kilene Short

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.