Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A49287 | CA |
NPI | 1295741668 |
---|---|
Provider Name | Dr. Laurence E Shields |
First Address | Santa Maria, CA 93454-6917 |
Second Address | Santa Maria, CA 93454-8905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 15/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A492870 | (05) | CA |
A492870 | BLUE SHIELD PIN (01) | CA |
AR271W | MEDICARE ID (01) | CA |