Active NPI
Shirley W Pang, M.D.
- Rheumatology Physician
- Fullerton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- A80798
- Practice address
- 2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830 - Phone
- (714) 626-8619
- Fax
- (714) 626-8693
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | A80798 | CA | Primary |
Addresses
Primary practice location
2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830
Mailing address
2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830
Phone (714) 626-8619
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A80798 | Other | CA | LICIENCE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | spang1373176@oc.providencedirect.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- University of California, Geffen School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006
1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144
1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350
2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175
253 S Diamond Bar Blvd
Diamond Bar, CA 91765-1606
Phone (909) 860-1144
5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 602-2400
8078 E Santa Ana Canyon Rd
Anaheim, CA 92808-1108
Phone (714) 974-2900
Hospital & facility affiliations
- Providence St. Jude Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A80798 | CA | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| St Jude Hospital Inc | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
2141 N Harbor Blvd
Ste 25000
Fullerton, CA 92835
Phone (714) 626-8610
279 Imperial Hwy
Ste 730
Fullerton, CA 92835
Phone (714) 449-4841
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- Hematology & Oncology Physician
- Orange, CA
- NPI 1801443510
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
-
- General Acute Care Hospital
- Brea, CA
- NPI 1891904942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1457437626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2141 N HARBOR BLVD STE 25000",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353830",
"telephone_number": "714-626-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2141 N HARBOR BLVD STE 25000",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353830",
"telephone_number": "714-626-8619",
"fax_number": "714-626-8693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANG",
"first_name": "SHIRLEY",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "A80798",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICIENCE NUMBER",
"identifier": "A80798",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "spang1373176@oc.providencedirect.org",
"affiliation": "N",
"address_1": "2141 N Harbor Blvd Ste 25000",
"city": "Fullerton",
"state": "CA",
"country_code": "US",
"postal_code": "928353830",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.