Individual
ELAINE SHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3234 MARYSVILLE BLVD, SACRAMENTO, CA 95815-1411
(918) 407-2495
Mailing address
1860 HOWE AVE STE 455, SACRAMENTO, CA 95825-1086
(918) 407-2495
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
58623
AZ
208000000X
Pediatrics Physician
Primary
A168601
CA
208000000X
Pediatrics Physician
R75544
AZ
Other
Enumeration date
05/04/2016
Last updated
06/12/2020
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