Provider Demographics
NPI:1245319631
Name:DAVID SHEK M.D.,INC.
Entity type:Organization
Organization Name:DAVID SHEK M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-772-9800
Mailing Address - Street 1:1401 S ANAHEIM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6214
Mailing Address - Country:US
Mailing Address - Phone:714-772-9800
Mailing Address - Fax:714-772-6800
Practice Address - Street 1:1401 S ANAHEIM BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6214
Practice Address - Country:US
Practice Address - Phone:714-772-9800
Practice Address - Fax:714-772-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30945261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346289915OtherNPI FOR DAVID SHEK M.D.
CA1245319631OtherNPI FOR DAVID SHEK MD INC
CA00A309450Medicaid
CA1346289915OtherNPI FOR DAVID SHEK M.D.