Etema Shilyansky, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A37752 Issued in CA

Practice address

416 W Las Tunas Dr
Suite 303
San Gabriel, CA 91776-1236

Phone

(626) 308-9220

Fax

(626) 308-9460

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740375088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 WINSTON AVE",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911081428",
            "telephone_number": "626-793-3761",
            "fax_number": "626-449-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE 303",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-308-9220",
            "fax_number": "626-308-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILYANSKY",
        "first_name": "ETEMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A37752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Sergeyevna Sharfman, BCBA
• Steven Shiang Yuan Shen, L.AC.
• Yen Yi Shen, AGACNP-BC
• Sheng H. Chang, M.D., Inc.
• Shi-Lin Niu D M D Inc (Shi-Lin Niu DMD., Ms.,Inc.)
• Jiyen Shin, O.D.
• Lum Bongwi Shu Lentina
• Tony K Shum, M.D.
• Han Sin Shyr
• Mary Judy Lo Sia Su, D.M.D.

• Internal Medicine Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.