NPIMap

Individual provider Active NPI

June Shao Withers, M.D.

  • General Practice Physician
  • Los Altos, CA
National Provider Identifier
1932103843
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A72572 Issued in CA
Practice address
4966 El Camino Real Ste 111
Los Altos, CA 94022-1406
Phone
(650) 224-5497
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A72572 CA Primary

Addresses

Primary practice location

4966 El Camino Real Ste 111
Los Altos, CA 94022-1406

Mailing address

4966 El Camino Real Ste 111
Los Altos, CA 94022-1406
Phone (650) 968-2389

Other identifiers 1

IdentifierTypeStateIssuer
00A725720MedicaidCA

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
I20040709001403 CA Practitioner - General PracticePractitioner - Interventional Pain ManagementPractitioner - Pain Management 7214915826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pain Management
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4966 El Camino Real
Suite 111
Los Altos, CA 94022-1406
Phone (650) 968-2389

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72572CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Medical Care, Inc. CurrentSince Apr 12, 2012 Accepting new patients
Fourth Optometric Care of California Past Accepting new patients
Fourth Optometric Care of California PastSince Apr 24, 2022 Accepting new patients

Locations

4966 El Camino Real
Ste 111
Los Altos, CA 94022
Phone (650) 224-5497

495 Castro St
Ste 102
Mountain View, CA 94041

Organizations & group practices 3

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1932103843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4966 EL CAMINO REAL STE 111",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221406",
            "telephone_number": "650-968-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4966 EL CAMINO REAL STE 111",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221406",
            "telephone_number": "650-224-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "JUNE",
        "middle_name": "SHAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A72572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A725720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

Verify at the official NPI Registry.