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Organization
SHAPARD ANESTHESIA MEDICAL GROUP INC
Active
Organization
SHAPARD ANESTHESIA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES W SHAPARD M.D. (PRESIDENT)
(714) 973-2650
Entity
Organization
Contact information
Practice address
39000 BOB HOPE DR, LAKEVIEW BLDG, RANCHO MIRAGE, CA 92270-3221
(760) 568-2684
Mailing address
PO BOX 2757, ORANGE, CA 92859-0757
(714) 973-2650
(714) 973-2655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A54534
CA
Other
Enumeration date
11/16/2006
Last updated
10/04/2007
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