Individual
SHANE LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 LAKEVILLE HWY, MOB-2, PETALUMA, CA 94954
(707) 765-3800
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2518
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
178185
CA
Other
Enumeration date
02/21/2014
Last updated
08/11/2022
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