Provider Demographics
NPI:1285681270
Name:SHAW, BASHIR AHMAD (MD)
Entity Type:Individual
Prefix:MR
First Name:BASHIR
Middle Name:AHMAD
Last Name:SHAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 S PAINTER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602
Mailing Address - Country:US
Mailing Address - Phone:562-698-9747
Mailing Address - Fax:562-698-9748
Practice Address - Street 1:7727 S PAINTER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602
Practice Address - Country:US
Practice Address - Phone:562-698-9747
Practice Address - Fax:562-698-9748
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A34842Medicare ID - Type Unspecified
A27597Medicare UPIN