| Shea Orthopedic And Sports Medicine Pc | |
|
1580 Creekside Drive Folsom CA 95630 | |
| (916) 984-4500 | |
| (915) 984-4502 |
| Full Name | Shea Orthopedic And Sports Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1580 Creekside Drive, Folsom, California |
| Authorized Official Name and Position | Michael A Shea (OWNER) |
| Authorized Official Contact | 9169844500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shea Orthopedic And Sports Medicine Pc 1580 Creekside Drive Folsom CA 95630 Ph: (916) 984-4500 | Shea Orthopedic And Sports Medicine Pc 1580 Creekside Drive Folsom CA 95630 Ph: (916) 984-4500 |
| NPI Number | 1225762917 |
|---|---|
| Provider Enumeration Date | 07/11/2022 |
| Last Update Date | 07/13/2022 |
| Medicare PECOS PAC ID | 4082097654 |
|---|---|
| Medicare Enrollment ID | O20220815000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225762917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 207XX0005X | Orthopaedic Surgery - Sports Medicine | (* (Not Available)) | Secondary |
| Provider Name | Michael A Shea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194875807 PECOS PAC ID: 1456449370 Enrollment ID: I20071109000599 |
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