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Organization
SHORE MDS MEDICAL CORP
Active
Organization
SHORE MDS MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY W SHORE M.D. (PRESIDENT)
(310) 792-3914
Entity
Organization
Contact information
Practice address
6801 PARK TER, LOS ANGELES, CA 90045-1543
(310) 665-7150
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 883-0386
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A123437
CA
Other
Enumeration date
04/12/2013
Last updated
11/21/2013
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