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Individual

DANIEL SHOCKET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
MSC 11 6093, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-5156
(505) 272-6225
Mailing address
2326 MOUNTAIN CREST CIR, THOUSAND OAKS, CA 91362-2655
(818) 687-7313

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2016-0271
NM
390200000X
Student in an Organized Health Care Education/Training Program
NM

Other

Enumeration date
04/12/2013
Last updated
12/20/2021
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