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TCHAKA B SHEPHERD MD INC NPI 1578875332


NPI Information

NPI: 1578875332
Provider Name: TCHAKA B SHEPHERD MD INC
Classification: Surgery - 2086S0127X
Entity Type: Organization

Specialization: Trauma Surgery

Address:
3628 E IMPERIAL HWY
SUITE 401
LYNWOOD, CA
ZIP 90262
Phone: (424) 213-4290
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TCHAKA B SHEPHERD MD INC is a trauma surgery surgery in Lynwood, CA. The provider is trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. TCHAKA B SHEPHERD MD INC NPI is 1578875332. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3628 E IMPERIAL HWY
SUITE 401
LYNWOOD, CA
ZIP 90262-643
Phone: (424) 213-4290

The provider's authorized official is Tchaka Shepherd .
The authorized official title is Owner and has the following contact phone number (310) 802-9735.

The enumeration date for this NPI number is 7/9/2010 and was last updated on 12/14/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0127XSurgeryTrauma SurgeryA72326CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11124078670OTHERCALIFORNIAPERSONAL NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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