Shine Healthcare Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A43383 Issued in CA

Legal business name

SHINE HEALTHCARE INC.

Practice address

12371 Imperial Hwy
Norwalk, CA 90650-3129

Phone

(562) 929-5000

Fax

(562) 375-6286

NPI assigned

Mar 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Praful Sarode, M.D.

Title

Ceo

Phone

(562) 929-5000

Specialties & licenses 7

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Isabel Christina Del Toro, NP-C

  • Family Nurse Practitioner
  • Norwalk, CA
  • NPI 1366902629
  NPD (past)
• Kenneth E Grubbs, D.O.

  • Family Medicine Physician
  • Orange, CA
  • NPI 1588773295
  NPD (past)
• Valerie Kay Lee, PA-C

  • Physician Assistant
  • Norwalk, CA
  • NPI 1578001640
  NPD (past)
• Saeeda Thara, M.D.

  • Pediatrics Physician
  • Norwalk, CA
  • NPI 1962747097
  NPD (past)

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343433600000",
    "number": "1568760239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12371 IMPERIAL HWY",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503129",
            "telephone_number": "562-929-5000",
            "fax_number": "562-375-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12371 IMPERIAL HWY",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503129",
            "telephone_number": "562-929-5000",
            "fax_number": "562-375-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2012-07-28",
        "status": "A",
        "authorized_official_last_name": "SARODE",
        "authorized_official_first_name": "PRAFUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-929-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A43383",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "CA",
            "license": "A43383",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A43383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willy Shea, DDS
• Nicholas Shepard
• Evan Sherin-Jones
• Shesobudha
• Yong Sang Shin, ACUPUNCTURIST
• Nerissa Sibal, MD
• Kayda Sieng
• Amberlyn Sierra, LCSW
• Greg Sierra
• Elizama Sigala

• Pediatrics Physician in Norwalk, CA
• Providers in Norwalk, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.