Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 88378 | CA |
N | 2086S0102X | Surgical Critical Care | ME62857 | FL |
NPI | 1306800339 |
---|---|
Provider Name | David V. Shatz |
First Address | Sacramento, CA 95817-2201 |
Second Address | Sacramento, CA 95817-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 09/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3711609-00 | (05) | FL |
F39194 | (02) | FL |