Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 13111 | NV |
Y | 207L00000X | Anesthesiologist | A123691 | CA |
NPI | 1003065376 |
---|---|
Provider Name | Alok Shukla |
First Address | Stockton, CA 95267-0096 |
Second Address | Merced, CA 95340-8319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 24/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CC072Y | (02) | CA |