Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnathan Shaw

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558725952

Johnathan Shaw is an Internal Medicine in Fontana, California. Graduated from Temple University School of Medicine in 2016, 10 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
10
Trained at
Temple University School of Medicine
In the registry since
2016
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Practice location Address checks out

9961 Sierra Ave
Fontana, CA 92335-6720
Phone: (909) 427-2608
Fax: (909) 427-5312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1558725952
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 12, 2016
Last updated in NPPESDecember 8, 2021
Certification dateDecember 8, 2021
Mailing address17234 Valley Blvd, Fontana, CA 92335

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolTEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fontana