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NPI Code Detail

MEDICARE: WILLIAM S.M. SHANAHAN MD

MEDICARE: WILLIAM S.M. SHANAHAN MD
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
12085R0202XDiagnostic Radiology PhysicianG41618CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100GH16180OTHERCAMEDI CAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
300G756000OTHERCABS OF CALIFORNIA

General Provider Information

NPI Number : 1013991116
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM S.M. SHANAHAN MD
Provider Business Mailing Address
First Line : P.O. BOX 511228
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-2997
Country : US
Telephone Number : 562-698-0811
Fax Number : 562-309-8200
Provider Business Practice Location Address
First Line : 12401 EAST WASHINGTON BLVD.
Second Line : PRESBYTERIAN INTERCOMMUNITY HOSP-RADIOLOGY DEPARTMENT
City : WHITTIER
State : CA
Zip : 90602-1006
Country : US
Telephone Number : 562-698-0811
Fax Number : 562-309-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 08/13/2012

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