NPIMap

Individual provider Active NPI

Emile George Shenouda, MD

  • Pediatrics Physician
  • South Gate, CA
National Provider Identifier
1760596845
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A56273 Issued in CA
Practice address
10132 California Ave
South Gate, CA 90280-6008
Phone
(323) 566-4411
Fax
(323) 566-0390
NPI assigned
Aug 18, 2006
Last updated
Jul 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A56273 CA Primary
General Practice Physician 208D00000X A56273 CA

Addresses

Primary practice location

10132 California Ave
South Gate, CA 90280-6008

Mailing address

10132 California Ave
South Gate, CA 90280-6008
Phone (310) 678-2291

Other identifiers 3

IdentifierTypeStateIssuer
00A562732MedicaidCA
00A562731MedicaidCA
00A562730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001074 CA Practitioner - Family Practice 1456308188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10132 California Ave
South Gate, CA 90280-6008
Phone (323) 566-4411

10136 California Ave
South Gate, CA 90280-6008
Phone (323) 566-4411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56273CAMDPharmacist
A56273CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L a Star Medical Group, Inc. Pediatrics Current Accepting new patients
Allied Care Community Health Center CurrentSince Apr 2, 2025 Accepting new patients
Sam H. Yoon, MD Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Emile G. Shenouda MD Inc. Pediatrics PastSince Feb 1, 2000 Accepting new patients
Gardena Hospital LP Past Accepting new patients
David Dung CHI Nguyen MD Inc Pediatrics Past Accepting new patients
Emile G. Shenouda MD, Inc Pediatrics Past Accepting new patients

Locations

10132 California Ave
South Gate, CA 90280
Phone (323) 212-5780

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGCJBA

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1760596845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "310-678-2291",
            "fax_number": "323-566-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10132 CALIFORNIA AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902806008",
            "telephone_number": "323-566-4411",
            "fax_number": "323-566-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOUDA",
        "first_name": "EMILE",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A56273",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A56273",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A562732",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A562731",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A562730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.