Individual provider · Type 1 NPI

Nicole Johnise Shaw, MD

Family Medicine Physician · South Gate, CA

NPI number 1780315473 Active

Practice location

4476 Tweedy Blvd Ste B
South Gate, CA 90280-6359

Call (323) 825-8300 Map

Fax (866) 372-2719

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XA204378 (CA)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1780315473

Nicole Johnise Shaw, MD's National Provider Identifier is 1780315473, issued on Jun 22, 2022. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in South Gate, CA. The record was last updated on Jun 10, 2026.