Individual
SHAWN M BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2510 AIRPARK DR, STE 301, REDDING, CA 96001-2449
(530) 242-3500
(530) 242-3546
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, 2ND FLOOR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
20A9922
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116018251
VIRGINIA MEDICAL LICENSE
VA
01
—
20A9922
CA MEDICAL LICENSE
CA
01
—
5101015098
MICHIGAN MEDICAL LICENSE
MI
01
—
SL0399
NEVADA MEDICAL LICENSE
NV
Enumeration date
03/09/2007
Last updated
09/27/2014
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