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Organization
PACIFIC COAST PEDIATRIC CENTER INC
Active
Organization
PACIFIC COAST PEDIATRIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA LEE SHAW MD (OWNER, PARTNER, SECY-TREAS)
(831) 722-0272
Entity
Organization
Contact information
Practice address
252 GREEN VALLEY RD, FREEDOM, CA 95019-3138
(831) 722-0272
(831) 722-1007
Mailing address
252 GREEN VALLEY RD, FREEDOM, CA 95019-3138
(831) 722-0272
(831) 722-1007
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36791
FICTITIOUS NAME PERMIT CA
CA
Enumeration date
12/31/2007
Last updated
01/01/2008
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