Individual
DR. CHARLES EDWARD SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4140 MOTHER LODE DR, SUITE 112, SHINGLE SPRINGS, CA 95682-8038
(530) 672-8059
(530) 672-2111
Mailing address
2256 UNIVERSITY AVE, SACRAMENTO, CA 95825-7082
(916) 972-7875
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC0108592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0108592
CHIROPRATIC LICENSE NUMBE
CA
05
—
THP70630F
—
CA
Enumeration date
01/09/2007
Last updated
07/09/2007
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