Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G40700 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | G40700 | CA |
N | 207NS0135X | Procedural Dermatology | G40700 | CA |
NPI | 1366432312 |
---|---|
Provider Name | Dr. John F Shega |
First Address | San Diego, CA 92123-2761 |
Second Address | San Diego, CA 92123-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 07/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48321 | (02) | CA |