Individual provider · Type 1 NPI
Edward Grant Shore, MD
Adult Medicine Physician · Van Nuys, CA
NPI number
1699846709
Active
Practice location
15243 Vanowen St Ste 412
Van Nuys, CA 91405-3662
Fax (818) 781-6644
Mailing address
4139 Camino De La Cumbre
Sherman Oaks, CA 91423-4023
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | G7953 (CA) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
Other adult medicine physician providers in Van Nuys
About NPI 1699846709
Edward Grant Shore, MD's National Provider Identifier is 1699846709, issued on Nov 11, 2006. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Van Nuys, CA. The record was last updated on Jul 8, 2007.