Kevin Micheal Shannon

M.D. | Pediatric Cardiology | Male

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Complete Profile:

Kevin Micheal Shannon basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Cardiology
Provider Name :	Kevin Micheal Shannon
Credential :	M.D.
Gender :	Male

Business Address:

Kevin Micheal Shannon address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	10833 Le Conte Ave Los Angeles, CA, 90095-3075 United States
Phone Number :	310-825-5296
Fax Number :	310-825-9524

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1629005368
NPI Entity Type :	Individual
First Enrolment Date :	27 Jun, 2006
Last Updated On :	27 Aug, 2013

Medicare Participation:

Kevin Micheal Shannon participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	8224051404
Medicare Enrollment ID :	I20060113000501
Primary Specialty :	Pediatric Medicine
Medical School :	Columbia University College Of Physicians And Surgeons
Graduation Year :	1987
Accepts Medicare?	Yes. Kevin Micheal Shannon accepts medicare insurance.

Group Practice Association:

Kevin Micheal Shannon is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Kevin Micheal Shannon is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Uc Regents	4587568829	73	10833 Leconte Ave Los Angeles, CA - 900953075 Ph: 3108259124	Yes
Uc Regents	4587568829	73	10833 Le Conte Ave Los Angeles, CA - 900953075	Yes
Uc Regents	4587568829	73	757 Westwood Plaza Ucla Dept Of Ped Grp Los Angeles, CA - 900958358 Ph: 3108258021	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kevin Micheal Shannon are as mentioned. Primary taxonomy code for Kevin Micheal Shannon, M.D. is 2080P0202X (Pediatrics Pediatric Cardiology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0202X	Pediatrics Pediatric Cardiology	Yes	G64023	CA

Legacy Identifiers:

Other legacy medical identifiers of Kevin Micheal Shannon such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
00G640230	MEDICAID	CA

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	10833 Le Conte Ave Los Angeles, CA, 90095-3075 United States
Phone Number :	310-825-5296
Fax Number :	310-825-9524

Business Location:

Patients can refer following map for directions to Kevin Micheal Shannon practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.