Kenneth Shan MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

KENNETH SHAN MD INC

Practice address

612 W Duarte Rd Ste 601
Arcadia, CA 91007-9240

Phone

(818) 659-5887

Fax

(320) 640-1309

NPI assigned

Mar 12, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Leo Shan, MDNPI 1629605431

Title

President

Phone

(818) 659-5887

Specialties & licenses 1

Addresses

Practitioners 1

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

• Kenneth Leo Shan, MD

  • Gastroenterology Physician
  • Arcadia, CA
  • NPI 1629605431

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1770430464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 601",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079240",
            "telephone_number": "818-659-5887",
            "fax_number": "320-640-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 601",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079240",
            "telephone_number": "818-659-5887",
            "fax_number": "320-640-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH SHAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-659-5887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lee Kendall, MS, LMFT
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• Anait Keorhagian
• Catherine Kestenian
• Kevin T Lee MD a Professional Corporation

• Gastroenterology Physician in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.