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Individual

MS. SHANNON MARJORIE FISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SHANNON FISH PA-C

Contact information

Practice address
450 BROADWAY ST, PAVILION A, 1ST FLOOR, REDWOOD CITY, CA 94063-3132
(650) 723-6238
(650) 721-3417
Mailing address
450 BROADWAY ST, PAVILION A, 1ST FLOOR, REDWOOD CITY, CA 94063-3132
(650) 723-6238
(650) 721-3417

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17422
CA

Other

Enumeration date
05/21/2008
Last updated
08/03/2012
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