RANDALL G. SHUE D.O. INC. NPI 1013265214

NPI Information

  • NPI: 1013265214
  • Provider Name: RANDALL G. SHUE D.O. INC.
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Other Name: LA PROCEDURE CLINIC
  • Address: 4055 E OLYMPIC BLVD
    SUITE 210
    LOS ANGELES, CA
    ZIP 90023
  • Phone: (323) 268-3491

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NPI Details

RANDALL G. SHUE D.O. INC. is a primary care clinic center in Los Angeles, CA. RANDALL G. SHUE D.O. INC. NPI is 1013265214. The provider is registered as an organization entity type.
The provider Other Name Is La Procedure Clinic.

The provider's business location address is:

4055 E OLYMPIC BLVD
SUITE 210
LOS ANGELES, CA
ZIP 90023-345
Phone: (323) 268-3491

The provider's authorized official is Randall G Shue .
The authorized official title is President and has the following contact phone number (323) 268-3491.

The enumeration date for this NPI number is 8/17/2012 and was last updated on 8/17/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary Care20A5142CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A93611MEDICARE UPINCALIFORNIA
200AX51420MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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