Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G37056 | CA |
NPI | 1053345009 |
---|---|
Provider Name | Stuart L. Shear |
First Address | Burbank, CA 91506-1706 |
Second Address | Burbank, CA 91506-1706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 21/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G370560 | (05) | CA |