GARY THOMAS SHAW


Address: 121 Sotoyome St, Santa Rosa, CA 95405-4823
Phone: 7075464062

GARY THOMAS SHAW (NPI# 1568542306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568542306
Entity Type Individual
Full Name GARY THOMAS SHAW
Credential M.D.
Practice Address 121 Sotoyome St
Santa Rosa
CA 95405-4823
Mailing Address Po Box 5651
Orange
CA 92863-5651
Practice Telephone 7075464062
Practice Fax Number 7075254097
Mailing Telephone 7145715000
Mailing Fax Number 7145715055
Enumeration Date 2006-10-16
Last Update Date 2014-06-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2085B0100X Radiology
Specialization: Body Imaging
G54948 CA Allopathic & Osteopathic Physicians
N 2085N0904X Radiology
Specialization: Nuclear Radiology
G54948 CA Allopathic & Osteopathic Physicians
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
G54948 CA Allopathic & Osteopathic Physicians
Y 2085R0204X Radiology
Specialization: Vascular & Interventional Radiology
G54948 CA Allopathic & Osteopathic Physicians
N 2085U0001X Radiology
Specialization: Diagnostic Ultrasound
G54948 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA 00G549480 05

Other Providers GARY SHAW

NPI Name Taxonomy Address Enumeration
1669667911 Gary Marshall Shaw Social Worker 1511 W Saint Johns Ave, Austin, TX 78757-1819 2007-09-10
1477689529 Gary Shaw Physical Therapist 3218 18th St Nw, Washington, DC 20010-1002 2007-02-25
1215026612 Gary Graham Shaw Dentist 435 W 600 N, Tremonton, UT 84337-2411 2006-10-12
1245576420 Gary Shaw Counselor 359 Fenn St, Administrative Offices, Pittsfield, MA 01201-5261 2012-12-17
1154587087 Gary R Shaw Dentist 4103 Bridgeport Way W, Ste A, University Place, WA 98466-4300 2008-07-30
1013921154 Gary H Shaw Internal Medicine 416 Connable Ave, Petoskey, MI 49770-2212 2006-07-27
1912940958 Gary Y. Shaw Otolaryngology 180 S Main St, Canton, IL 61520-2608 2006-06-14

Office Location

Street Address 121 SOTOYOME ST
City SANTA ROSA
State CA
Zip Code 95405-4823

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023089729 Marlene Patricia Lennon Nurse Practitioner 121 Sotoyome St, Santa Rosa, CA 95405-4823 2006-01-30
1821417296 Nicholas Mcgarvey Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2014-04-14
1326461708 Redwood Radiology Group Inc Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2014-01-21
1225471337 Alexander Page Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2013-04-09
1275819641 Kathleen A Mott Nurse Practitioner 121 Sotoyome St, Santa Rosa, CA 95405-4823 2011-10-28
1720373376 Anusuya Mokashi Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2011-06-12
1558651091 Vivek G. Sahani Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2011-04-18
1043531643 Gary Raymond Roper Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2010-06-17
1316176712 Lesley M Field Physician Assistant 121 Sotoyome St, Santa Rosa, CA 95405-4823 2009-07-07
1578797601 Raymond F. Conway IIi Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2009-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083230486 Lizett Camacho Counselor 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 2020-06-22
1346768918 Ingrid Tsong Student in an Organized Health Care Education/Training Program 3447 Summerfield Road, Santa Rosa, CA 95405 2017-09-05
1275051898 Jessica Peters Malmberg Student in an Organized Health Care Education/Training Program 2447 Summerfield Rd, Santa Rosa, CA 95405 2017-09-04
1306246772 Kirsten Eckert Advanced Practice Midwife 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 2014-09-03
1982034294 Mohammad Reza Saeidi Dentist 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 2013-11-22
1851631642 Debi M. Emmons Marriage & Family Therapist 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 2013-02-15
1841549979 Karie Louise Klim Marriage & Family Therapist 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 2012-09-05
1427314400 Rachel E. Page Counselor 2447 Summerfield Rd., Santa Rosa, CA 95405 2012-04-04
1689991572 Center for Integral Healing Inc. Community Health Worker 182 Farmers Lane, #203, Santa Rosa, CA 95405 2010-04-30
1588997647 Kai Morgan Dentist 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 2009-09-08
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Taxonomy Information

Taxonomy Code 2085R0204X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Vascular & Interventional Radiology

Taxonomy Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225471337 Alexander Page Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2013-04-09
1558651091 Vivek G. Sahani Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2011-04-18
1578797601 Raymond F. Conway IIi Radiology 121 Sotoyome St, Santa Rosa, CA 95405-4823 2009-05-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1134739949 Ava Vascular Radiology 1281 W. C. Street, Suite 200, Colton, CA 92324 2020-08-06
1306467204 Saleh Radiology of Inland Empire Radiology 15276 Ledgestone St, Fontana, CA 92336-4048 2020-05-01
1366084535 Luo Xu Radiology 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 2019-10-09
1346717824 Cvs Medical Group, Inc Radiology 201 W Garvey Ave Ste 102-502, Monterey Park, CA 91754-7418 2018-11-01
1407353675 Art Vascular & Interventional Associates Inc Radiology 324 S Beverly Dr Ste 345, Beverly Hills, CA 90212-4801 2018-04-12
1568971869 Broad Reach Specialty Surgery Inc Radiology 8117 West Manchester Ave, Ste 368, Playa Del Rey, CA 90293 2017-09-29
1407393754 Valley Vascular Partners Inc Radiology 19231 Victory Blvd Ste 155, Reseda, CA 91335-6329 2017-01-25
1124497342 Neurointerventional Surgery Consultants, PC Radiology 534 S Brea Blvd, Brea, CA 92821-5304 2015-09-17
1578946026 Clarity Radiology, LLC Radiology 39 Via Navarro, Greenbrae, CA 94904-1215 2015-07-01
1669863981 Pedes Vascular San Fernando Valley Radiology 16260 Ventura Boulevard, Suite 210, Encino, CA 91436-2203 2015-02-09
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Competitor

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City SANTA ROSA
Zip Code 95405

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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