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RANDALL G. SHUE D.O. INC. NPI 1770758187


NPI Information

NPI: 1770758187
Provider Name: RANDALL G. SHUE D.O. INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4055 E OLYMPIC BLVD
#210
LOS ANGELES, CA
ZIP 90023
Phone: (323) 268-3491
Get Directions

RANDALL G. SHUE D.O. INC. is a family medicine in Los Angeles, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RANDALL G. SHUE D.O. INC. NPI is 1770758187. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4055 E OLYMPIC BLVD
#210
LOS ANGELES, CA
ZIP 90023-345
Phone: (323) 268-3491

The provider's authorized official is Randall G. Shue .
The authorized official title is Owner and has the following contact phone number (323) 268-3491.

The enumeration date for this NPI number is 4/25/2008 and was last updated on 4/25/2008.


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
1207Q00000XFamily Medicine20A5142CALIFORNIAYes

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
1A93611MEDICARE UPINCALIFORNIA
200AX5142MEDICAIDCALIFORNIA
3W20A5142DMEDICARE PINCALIFORNIA

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: 11/14/2023

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