# SHAW MEDICAL GROUP PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** REGAL FAMILY PRACTICE MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306213889
- **Authorized official:** DR. BETSY ALCID SHAW MD (PRESIDENT)
- **Authorized official phone:** (310) 533-9233

## Contact information

- **Practice address:** 1001 W CARSON ST, SUITE I, TORRANCE, CA 90502-2051
- **Practice address phone:** (310) 533-9233
- **Practice address fax:** (310) 533-9292
- **Mailing address:** 1001 W CARSON ST, SUITE I, TORRANCE, CA 90502-2051
- **Mailing address phone:** (310) 533-9233
- **Mailing address fax:** (310) 533-9292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207QA0505X | Adult Medicine Physician | — | — | — |
| 261QC1500X | Community Health Clinic/Center | A42535 | CA | Yes |

## Other

- **Enumeration date:** 08/31/2015
- **Last updated:** 07/25/2019