NPIMap

Organization Active NPI

Elite Multispecialty Medical Group Inc

Doing business as Elite Multispecialty Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1902036742
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A56075 Issued in CA
Legal business name
ELITE MULTISPECIALTY MEDICAL GROUP INC
Doing business as
Elite Multispecialty Medical Group
Practice address
2010 Wilshire Blvd
Suite 2012
Los Angeles, CA 90057-3507
Phone
(213) 481-1111
Fax
(213) 481-1112
NPI assigned
Jul 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Dr. Shane Sheibani, M.D.NPI 1285823757
Title
President
Phone
(213) 481-1111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A56075 CA Primary

Addresses

Primary practice location

2010 Wilshire Blvd
Suite 2012
Los Angeles, CA 90057-3507

Mailing address

2010 Wilshire Blvd
Suite 2012
Los Angeles, CA 90057-3507
Phone (213) 481-1111

Other names 1

  • Elite Multispecialty Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

2010 Wilshire Blvd
Unit 2012
Los Angeles, CA 90057
Phone (213) 481-1111

2010 Wilshire Blvd
Ste 2012
Los Angeles, CA 90057
Phone (213) 481-1111

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1902036742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "SUITE 2012",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-481-1111",
            "fax_number": "213-481-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD",
            "address_2": "SUITE 2012",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573507",
            "telephone_number": "213-481-1111",
            "fax_number": "213-481-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MULTISPECIALTY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "SHEIBANI",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-481-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A56075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Multispecialty Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.