Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | G24044 | CA |
NPI | 1073527198 |
---|---|
Provider Name | Dr. Perry Michael Shoor |
First Address | Atherton, CA 94027-6430 |
Second Address | San Carlos, CA 94070-2317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 03/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A42143 | (02) | CA |
CP2153 | RAILROAD MEDICARE (01) | CA |