Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G40378 | CA |
NPI | 1316967326 |
---|---|
Provider Name | Dr. James Robert Shields |
First Address | Tarzana, CA 91356-3505 |
Second Address | Tarzana, CA 91356-3505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |