Individual
AMY WALL SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4553 GLENCOE AVE STE 100, MARINA DEL REY, CA 90292-7917
(949) 988-7800
Mailing address
1590 ROSECRANS AVE STE D, MANHATTAN BEACH, CA 90266-3716
(310) 737-2844
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
226228
MA
207L00000X
Anesthesiology Physician
Primary
30993
AL
207L00000X
Anesthesiology Physician
A123437
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01600227
—
MS
01
—
051120729
BCBS
AL
01
—
051120731
BCBS
AL
01
—
051120732
BCBS
AL
01
—
051120734
BCBS
AL
05
—
132222
—
AL
05
—
132224
—
AL
05
—
132226
—
AL
05
—
132231
—
AL
Enumeration date
05/06/2008
Last updated
11/15/2025
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