Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | G55169 | CA |
N | 208800000X | Urologist | G55169 | CA |
NPI | 1417915406 |
---|---|
Provider Name | Dr. Donald Brian Shaul |
First Address | Encino, CA 91416-6310 |
Second Address | Encino, CA 91316-5225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G551690 | MEDICAL ID NUMBER (01) | CA |
10964 | CCS NUMBER (01) | CA |