Individual
MICHAEL S SHAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 E HARDY ST, CENTINELA HOSPITAL MEDICAL CENTER, INGLEWOOD, CA 90301
(310) 673-4660
Mailing address
PO BOX 5686, ORANGE, CA 92863-5686
(888) 598-8819
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G16831
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G168310
BLUE SHIELD
—
05
—
00G168310
—
CA
01
—
00G168310E02
CALOPTIMA
—
01
—
050739CA39924
TRAILBLAZER
—
01
—
360002809
RAILROAD MEDICARE
—
Enumeration date
11/29/2005
Last updated
08/15/2008
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