| William R. Shankle Md Inc. | |
|
3900 W Coast Hwy Ste 310 Newport Beach CA 92663 | |
| (949) 478-8858 | |
| (949) 242-2465 |
| Full Name | William R. Shankle Md Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3900 W Coast Hwy Ste 310, Newport Beach, California |
| Authorized Official Name and Position | Georgette Youssef (OPERATIONS MANAGER) |
| Authorized Official Contact | 9494788858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William R. Shankle Md Inc. 3900 W Coast Hwy Ste 310 Newport Beach CA 92663 Ph: (949) 478-8858 | William R. Shankle Md Inc. 3900 W Coast Hwy Ste 310 Newport Beach CA 92663 Ph: (949) 478-8858 |
| NPI Number | 1265078786 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 08/20/2021 |
| Certification Date | 08/20/2021 |
| Medicare PECOS PAC ID | 8921416280 |
|---|---|
| Medicare Enrollment ID | O20210426002722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265078786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | William R Shankle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932246584 PECOS PAC ID: 9234279563 Enrollment ID: I20091217000599 |
| Provider Name | Sarah Kristine Alcaide Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942708383 PECOS PAC ID: 7618223611 Enrollment ID: I20180705001639 |
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