NPIMap

Organization Active NPI

Executive Gi Services

Doing business as Executive GI Services, Inc.

  • Certified Registered Nurse Anesthetist
  • Danville, CA
National Provider Identifier
1669730339
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
EXECUTIVE GI SERVICES
Doing business as
Executive GI Services, Inc.
Practice address
1320 El Capitan Dr
Suite 110
Danville, CA 94526-6258
Phone
(925) 866-9300
Fax
(866) 867-2984
NPI assigned
May 1, 2012
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Dr. Salim M Shelby, M.D.NPI 1215948161
Title
President
Phone
(925) 866-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X
Clinical Informatics (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0008X
Anatomic Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0101X
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1320 El Capitan Dr
Suite 110
Danville, CA 94526-6258

Mailing address

12935 Alcosta Blvd Unit 3888
San Ramon, CA 94583-6181
Phone (925) 718-6622

Other names 1

  • Executive GI Services, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120625000277 CA Part B Supplier - Clinic/Group Practice 2163687146 Receives reassigned benefits from 15 practitioners
Practice locations: Danville, CA

National Provider Directory

National Provider Directory

Locations

12935 Alcosta Blvd
Unit 3888
San Ramon, CA 94583

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1669730339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12935 ALCOSTA BLVD UNIT 3888",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945836181",
            "telephone_number": "925-718-6622",
            "fax_number": "917-259-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DR",
            "address_2": "SUITE 110",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266258",
            "telephone_number": "925-866-9300",
            "fax_number": "866-867-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE GI SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "SHELBY",
        "authorized_official_first_name": "SALIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-866-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Informatics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Executive GI Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Executive GI Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.