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RANDALL G. SHUE D.O. INC.
NPI 1770758187
Family Medicine in Los Angeles, CA

Active since April 25, 2008
4055 E OLYMPIC BLVD, #210, LOS ANGELES, CA 90023(323) 268-3491 Get Directions Write a Review

NPPES record last updated: April 25, 2008. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Randall G. Shue D.o. Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDALL G. SHUE D.O. INC. (NPI 1770758187) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since April 2008. The organization lists Randall G. Shue, Owner, as its authorized official.

NPPES Registry Identity

NPI1770758187
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRANDALL G. SHUE D.O. INC.
Location Address4055 E OLYMPIC BLVD, #210Los Angeles, CA 90023-3345
Mailing Address4055 E Olympic Blvd, #210Los Angeles, CA 90023-3345 · (323) 268-3491
Phone(323) 268-3491
Organization SubpartNo
Authorized OfficialRandall G. ShueOwner · (323) 268-3491
Enumeration DateApril 25, 2008
✔ NPI 1770758187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 20A5142
Definition
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.
4055 E OLYMPIC BLVD, Los Angeles, CA 90023
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Other Identifiers 3

Medicare UPINA93611CA
Medicaid00AX5142CA
Medicare PINW20A5142DCA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randall G. Shue D.o. Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Randall G. Shue D.O. Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Randall Shue, D.O.
Family Practice
NPI 1679576730
4055 E OLYMPIC BLVD STE 210
Los Angeles, CA 90023
(323) 268-3491
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randall G. Shue D.O. Inc.'s NPI number?

The NPI number for Randall G. Shue D.O. Inc. is 1770758187. It was assigned to this organization in the NPPES registry on April 25, 2008.

Where is Randall G. Shue D.O. Inc. located?

Randall G. Shue D.O. Inc. is located at 4055 E Olympic Blvd #210, Los Angeles, CA 90023. The listed phone number is (323) 268-3491.

What is Randall G. Shue D.O. Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Randall G. Shue D.O. Inc. enrolled in Medicare?

Yes. Randall G. Shue D.O. Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Randall G. Shue D.O. Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Randall G. Shue D.O. Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Randall G. Shue D.O. Inc. was last updated on April 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.