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Individual
SHANE ANDREW TIPTON
Active
Individual
SHANE ANDREW TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
PA17521
CA
363A00000X
Physician Assistant
Primary
17521
CA
364SE0003X
Emergency Clinical Nurse Specialist
PA17521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OPA175210
—
CA
Enumeration date
01/18/2006
Last updated
02/07/2025
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