James W Shaner M D A Medical Corporation | |
173 S Civic Dr Ste 4 Palm Springs CA 92262-7215 | |
(760) 864-6688 | |
(760) 864-6686 |
Full Name | James W Shaner M D A Medical Corporation |
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Speciality | Clinic/Center |
Location | 173 S Civic Dr, Palm Springs, California |
Authorized Official Name and Position | James Shaner (DOCTOR) |
Authorized Official Contact | 7608646688 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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James W Shaner M D A Medical Corporation 173 S Civic Dr Suite 4 Palm Springs CA 92262-7215 Ph: (760) 864-6688 | James W Shaner M D A Medical Corporation 173 S Civic Dr Ste 4 Palm Springs CA 92262-7215 Ph: (760) 864-6688 |
NPI Number | 1083917918 |
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Provider Enumeration Date | 12/15/2010 |
Last Update Date | 03/21/2011 |
Medicare PECOS PAC ID | 2365620390 |
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Medicare Enrollment ID | O20110622000465 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083917918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | G25057 (California) | Primary |
Provider Name | James Shaner |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1477663821 PECOS PAC ID: 8022296862 Enrollment ID: I20110628000007 |
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