Physician Compare National (NPI:1922041102)

HEALTHCARE PROVIDER: VALERIE GRANT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1922041102
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921093303
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040416000339
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRANT
	Individual professional last name
Provider First Name	VALERIE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	DR MONA SHAH PROFESSIONAL CORPORATION
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2062548084
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1600 S GAFFEY ST
	Group Practice or individual's line 1 address
City	SAN PEDRO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	907314628
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3105480201
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050078
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y