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General NPI Number Information
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NPI Number | 1619154457
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Entity Type | Organization
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Legal Business Name | SYLVIA J SHAW MD A MEDICAL CORP
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 3633 MLK BLVD #2
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City | LYNWOOD
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State | CA
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Zip | 90262
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Country | US
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Telephone | 310-537-6397
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Fax | 310-537-7550
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Provider Business Mailing Address
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Address Line | 3633 MLK BLVD #2
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City | LYNWOOD
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State | CA
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Zip | 90262
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Country | US
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Telephone | 310-537-6397
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Fax | 310-537-7550
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Authorized Official
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Title or Position | OWNER
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Name | SYLVIA J SHAW
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Credential | MD
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Telephone | 310-537-6397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | G50246
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License Number State | CA
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