Individual
DR. GERON F. SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, A108, LOMA LINDA, CA 92354-2804
(909) 558-7171
(909) 558-0121
Mailing address
PO BOX 20130, RIVERSIDE, CA 92516-0130
(323) 908-7615
(323) 924-5971
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2011001502
MO
207P00000X
Emergency Medicine Physician
Primary
G064395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
06/07/2006
Last updated
10/02/2015
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