Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | A123643 | CA |
Y | 207RX0202X | Medical Oncology | A123643 | CA |
NPI | 1306135470 |
---|---|
Provider Name | Casie Schedel Shenoy |
First Address | San Diego, CA 92123-2773 |
Second Address | Sacramento, CA 95817-1460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2011 |
Last Update Date | 25/04/2017 |