Tracie Shaw, DPM
Podiatrist, Foot & Ankle Surgery in Chino, CA. Individual provider (NPI-1).
NPI number1659948321
StatusActive
Last updated in NPPESAug 13, 2024
Details
- NPI
- 1659948321
- Entity type
- Individual (NPI-1)
- Name
- Tracie Shaw
- Credential
- DPM
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 9, 2021
- Certification date
- Aug 13, 2024
- Last updated
- Aug 13, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PODIATRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | E5975 | CA | Yes |
Practice location
5365 Walnut Ave Ste PChino, CA 91710-2622
Phone 909-946-6643
Mailing address
1039 S Indian Summer AveWest Covina, CA 91790-5216
Phone 626-660-5239
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Foot & Ankle Surgery Podiatrist providers in Chino, CA
- Andrew AttiaNPI 1255906285
- Jessica S Chong, D.P.M.NPI 1396021002
- Christopher C. Bautista, Dpm INCNPI 1952741092
- Farid DidariNPI 1477944114
- Foot And Ankle Care Team INCNPI 1649740556
- Jessica Chong Dpm Mph INCNPI 1043664857
All 7 Foot & Ankle Surgery Podiatrist providers in Chino · All 1,655 providers in Chino
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