Shunrie Geldore, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

30 Nightingale Rd
Edwards AFB, CA 93524-0001

Phone

(661) 275-7938

NPI assigned

Feb 23, 2012

Last updated

Feb 23, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1780958645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NIGHTINGALE RD",
            "city": "EDWARDS AFB",
            "state": "CA",
            "postal_code": "935240001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NIGHTINGALE RD",
            "city": "EDWARDS AFB",
            "state": "CA",
            "postal_code": "935240001",
            "telephone_number": "661-275-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELDORE",
        "first_name": "SHUNRIE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asit Hirenkumar Dave, DO
• Karen Ann Desocio, LCSW
• Joseph Mitchell Duren Jr., M.D.
• James Randall Elliott, MD, MPH
• Joshua Chad Ford, DPT
• Kallyn Dorothy Harencak, M.D.
• Michael Hasler, M.D.
• Arlene Johnson, LCSW
• Ain Kang
• Jun Kyung Ko, DMD, ABGD

• Physician Assistant in Edwards AFB, CA
• Providers in Edwards AFB, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.