Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | A108851 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A08851 | CA |
NPI | 1588836274 |
---|---|
Provider Name | Shawn Uraine |
First Address | Loma Linda, CA 92354-0119 |
Second Address | Loma Linda, CA 92354-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2008 |
Last Update Date | 24/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1588836274 | NPI (01) | CA |