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Individual
SHANNON SULLIVAN
Active
Individual
SHANNON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A81983
CA
2080P0214X
Pediatric Pulmonology Physician
A81983
CA
2080S0012X
Pediatric Sleep Medicine Physician
A81983
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A81983
CA MEDICAL LICENSE
CA
Enumeration date
04/09/2007
Last updated
04/18/2011
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