MEDICARE: MS. ELAINE CAROLE SHOJI 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	208000000X	Pediatrics Physician	G35402	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G35402	OTHER	CA	STATE LICENSE
2	33-0277966	OTHER	CA	FEDERAL TAX I.D.

General Provider Information

NPI Number	:	1538265160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE CAROLE SHOJI M.D.

Provider Business Mailing Address
First Line	:	827 DEEP VALLEY DR
Second Line	:	SUITE 102
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3647
Country	:	US
Telephone Number	:	310-541-8801
Fax Number	:	310-541-8703

Provider Business Practice Location Address
First Line	:	827 DEEP VALLEY DR
Second Line	:	SUITE 102
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3647
Country	:	US
Telephone Number	:	310-541-8801
Fax Number	:	310-541-8703

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	01/24/2012

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Directions to “ MS. ELAINE CAROLE SHOJI M.D.” Practice Location

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