Individual
DR. SAM SHIESHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FAAFP
Contact information
Practice address
25101 BEAR VALLEY RD, PMB 347, TEHACHAPI, CA 93561-8311
(661) 335-2891
Mailing address
25101 BEAR VALLEY RD, PMB 347, TEHACHAPI, CA 93561-8311
(661) 335-2891
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
A46051
CA
207QA0505X
Adult Medicine Physician
Primary
A46051
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A460510
—
CA
Enumeration date
09/21/2006
Last updated
10/20/2011
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