MEDICARE: SHAHEM KAWJI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A93120	CA
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	A93120	CA
3	207W00000X	Ophthalmology Physician	A93120	CA

General Provider Information

NPI Number	:	1326059387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHEM KAWJI M.D.

Provider Business Mailing Address
First Line	:	20311 SW BIRCH ST STE 150
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1779
Country	:	US
Telephone Number	:	949-427-2020
Fax Number	:	949-579-2601

Provider Business Practice Location Address
First Line	:	20311 SW BIRCH ST STE 150
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1779
Country	:	US
Telephone Number	:	949-427-2020
Fax Number	:	949-579-2601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	10/04/2021

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