Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC23111 | CA |
NPI | 1659560639 |
---|---|
Provider Name | Dr. Kenn Scott Shoji |
First Address | Sacramento, CA 95825-0431 |
Second Address | Sacramento, CA 95825-0431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 16/10/2007 |