Tchaka B Shepherd MD Inc

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

A72326 Issued in CA

Legal business name

TCHAKA B SHEPHERD MD INC

Practice address

3628 E Imperial Hwy
Suite 401
Lynwood, CA 90262-2643

Phone

(424) 213-4290

NPI assigned

Jul 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Tchaka Shepherd, MD

Title

Owner

Phone

(310) 802-9735

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1578875332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1250",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902780250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 E IMPERIAL HWY",
            "address_2": "SUITE 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622643",
            "telephone_number": "424-213-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TCHAKA B SHEPHERD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "TCHAKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-802-9735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A72326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1124078670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odette R Tawadrous, MD
• Jonathan Taylor
• Nykia Taylor
• Tatonia R Taylor
• Tomanika Taylor
• Terence TZ. Tan,MD,Inc.
• Rita Thapa, NP
• Darit Thienprasit, MD
• Evangela Ann Thomas, NP
• Gaylynn Tracell Thomas, LCSW

• Trauma Surgery Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Trauma Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.