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Organization
SOVEREIGN PALADIN INC
Active
Organization
SOVEREIGN PALADIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MARK SHIDELER MD (CEO OWNER)
(937) 219-8735
Entity
Organization
Contact information
Practice address
6080 CENTER DR, LOS ANGELES, CA 90045-9209
(424) 512-2300
Mailing address
12444 NW 10TH STREET, STE 202, BOX 175, YUKON, OK 73099
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/12/2026
Last updated
08/12/2026
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