TCHAKA B SHEPHERD MD INC (NPI# 1578875332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578875332 |
| Entity Type | Organization |
| Organization Name | TCHAKA B SHEPHERD MD INC |
| Practice Address |
3628 E Imperial Hwy Suite 401 Lynwood CA 90262-2643 |
| Mailing Address |
Po Box 1250 Redondo Beach CA 90278-0250 |
| Practice Telephone | 4242134290 |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-12-14 |
| Authorized Official Name | DR. TCHAKA SHEPHERD (OWNER) |
| Authorized Official Telephone | 3108029735 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
A72326 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PERSONAL NPI | 1124078670 | 01 |
| Street Address |
3628 E IMPERIAL HWY SUITE 401 |
| City | LYNWOOD |
| State | CA |
| Zip Code | 90262-2643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621813 | Fairveola Banks | Pharmacy | 3628 E Imperial Hwy, Ste 102, Lynwood, CA 90262-2643 | 2005-09-29 |
| 1043753353 | Candita Potts | Nurse Practitioner | 3628 E Imperial Hwy, Lynwood, CA 90262-2643 | 2016-11-18 |
| 1760811251 | David Friedberg, Md Inc. | Orthopaedic Surgery | 3628 E Imperial Hwy, Suite 300, Lynwood, CA 90262-2643 | 2013-11-05 |
| 1720320542 | Michael Angel Jimenez, Md, Inc. | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2013-03-19 |
| 1558689984 | Kimberly Sobell Heugele | Pediatrics | 3628 E Imperial Hwy, Suite #301, Lynwood, CA 90262-2643 | 2010-05-10 |
| 1750608485 | Jane Lee Gin | Surgery | 3628 E Imperial Hwy, Suite 408, Lynwood, CA 90262-2643 | 2010-04-20 |
| 1164748786 | Almaas Shaikh, Md Inc | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2010-04-08 |
| 1639342330 | Maxine M. Anderson, M.d., Inc. | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2008-04-02 |
| 1710175641 | Gracie-ann Dinkins Md Inc | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2007-10-04 |
| 1750571352 | Mona Shah | Surgery | 3628 E Imperial Hwy, Suite 202, Lynwood, CA 90262-2643 | 2007-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546062 | Sheila Maxine Wilkins | Technician | 3940 Palm Ave, Lynwood, CA 90262 | 2019-09-10 |
| 1891344669 | Chezoma Latissue Davis | Technician | 4255 Niland St, Lynwood, CA 90262 | 2019-09-05 |
| 1295223345 | Scla Comprehensive Surgical Medical Group, Inc. | Clinic/Center | 3628 E Imperial Hwy Ste 204, Lynwood, CA 90262 | 2018-04-24 |
| 1891213807 | Grecia Veronica Nunez | Case Manager/Care Coordinator | 3680 E. Imperial Highway, Suite 200, Lynwood, CA 90262 | 2017-08-30 |
| 1134643448 | Angelica Jazmin Alonso Cortes | Case Manager/Care Coordinator | 2610 Industry Way Suite A, Lynwood, CA 90262 | 2017-07-28 |
| 1134594997 | Corinne Palma | Counselor | 11705 S. Alameda St., Lynwood, CA 90262 | 2015-12-04 |
| 1891175550 | Nancy Bremmer | Counselor | 10705 S. Alameda Street, Los Angels, CA 90262 | 2015-06-08 |
| 1588041347 | Jennifer Montoya | Case Management | 5433 E. Pelleur St., Lynwood, CA 90262 | 2015-04-30 |
| 1124440060 | Susana Gyek Goy | Chiropractor | 11123 Long Beach Blvd. Suite 5, Lynwood Health Center, Lynwood, CA 90262 | 2014-01-13 |
| 1215368956 | Baart Community Healthcare | Clinic/Center | 11315 S. Atlantic Blvd., Lynwood, CA 90262 | 2013-12-05 |
| Find all providers in zip 90262 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164748786 | Almaas Shaikh, Md Inc | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2010-04-08 |
| 1639342330 | Maxine M. Anderson, M.d., Inc. | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2008-04-02 |
| 1710175641 | Gracie-ann Dinkins Md Inc | Surgery | 3628 E Imperial Hwy, Suite 401, Lynwood, CA 90262-2643 | 2007-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558809277 | Southern California Hepatobiliary Pancreatic and Robotic Surgery Ins | Surgery | 5805 Sepulveda Blvd Ste 690, Sherman Oaks, CA 91411 | 2017-02-01 |
| 1609212919 | Daniel Eldridge Smith | Surgery | 11175 Campus St # 21111, Loma Linda, CA 92350 | 2013-05-14 |
| 1841553187 | Ning Lu | Surgery | 9898 Genesee Ave Fl 1, La Jolla, CA 92037-1205 | 2012-06-21 |
| 1942588868 | Trauma & Critical Care Sfv Group Inc | Surgery | 11550 Indian Hills Road, Suite 310, Mission Hills, CA 91345 | 2011-07-26 |
| 1467652859 | Trauma Vascular Surgeons Inc | Surgery | 12400 Ventura Blvd # 374, Studio City, CA 91604-2406 | 2007-07-23 |
| 1194819532 | North County Trauma Services, Inc. | Surgery | 451 March Avenue, Suite B, Healdsburg, CA 95448-3387 | 2006-10-02 |
| 1598863193 | Lawrence Roberts | Surgery | 7930 Frost St Ste 204, San Diego, CA 92123-2739 | 2006-09-20 |
| 1467563791 | North County Trauma Associates, Inc. A Medical Group | Surgery | 215 South Hickory Avenue, Suite 112, Escondido, CA 92025-4360 | 2006-08-31 |
| 1922116987 | Dinh Nhatton Nguyen | Surgery | 1800 Harrison St Fl 7, Oakland, CA 94612-3466 | 2006-08-29 |
| 1477564474 | Todd A Kanen | Surgery | 5333 Hollister Ave Ste 210, Santa Barbara, CA 93111-3331 | 2006-08-11 |
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| 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.