Individual
SHAWN RENEE VAN BOCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, DIAGNOSTIC IMAGING, SAN JOSE, CA 95128-2604
(408) 885-6370
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G50905
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G509050
—
CA
Enumeration date
10/03/2006
Last updated
09/12/2007
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