Individual
PAUL RICHARD SHONKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3536 MENDOCINO AVE, STE 300, SANTA ROSA, CA 95403-3634
(707) 575-6033
(707) 568-5942
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 568-5942
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2738
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E2738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E27380
BLUE SHIELD OF CALIFORNIA
CA
05
—
000E27380
—
CA
01
—
480029370
RAILROAD MEDICARE
CA
Enumeration date
07/13/2005
Last updated
02/07/2012
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