MEDICARE: SHIELD CALIFORNIA HEALTH CARE CENTER INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)

General Provider Information

NPI Number	:	1356225866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIELD CALIFORNIA HEALTH CARE CENTER INC

Provider Business Mailing Address
First Line	:	27911 FRANKLIN PKWY
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4110
Country	:	US
Telephone Number	:	661-294-4217
Fax Number	:

Provider Business Practice Location Address
First Line	:	9444 FARNHAM ST STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1300
Country	:	US
Telephone Number	:	800-458-7718
Fax Number	:	858-277-4682

Authorized Official
Title or Position	:	VP AND GENERAL MANAGER
Name	:	MICHAEL SUOR
Credential	:
Telephone Number	:	661-294-4217

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/05/2025

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