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Individual

GLENN SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2025 SOQUEL AVE, SANTA CRUZ, CA 95062-1323
(831) 423-4111
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A64298
CA
208M00000X
Hospitalist Physician
Primary
A64298
CA

Other

Enumeration date
01/20/2006
Last updated
02/25/2021
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