Individual
SHANNON SAN SAN WAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-8800
Mailing address
3020 CHILDRENS WAY, MC5075, SAN DIEGO, CA 92123-4223
(858) 966-8800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A122459
CA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
A122459
CA
Other
Enumeration date
11/17/2009
Last updated
02/20/2013
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