Individual
SHAWN CHARLES LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3315 BROADWAY, OAKLAND, CA 94611-5717
(510) 486-2300
(510) 486-2333
Mailing address
200 PORTER DR, 215, SAN RAMON, CA 94583-1587
(925) 362-2166
(855) 574-3055
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA52420
CA
Other
Enumeration date
08/26/2009
Last updated
05/11/2017
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