Individual
JAMES BURR SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1680 S MELROSE DR, SUITE 105, VISTA, CA 92081-5472
(760) 632-7246
(760) 942-8878
Mailing address
7040 AVENIDA ENCINAS, #104-248, CARLSBAD, CA 92011-4652
(760) 632-7246
(760) 942-8878
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
A45657
CA
208VP0000X
Pain Medicine Physician
Primary
A45657
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103340
QME
CA
01
—
614888500
WORK COMP DOL
CA
01
—
A-45657
STATE LICENSE
CA
01
—
P00712842
MEDICARE RAILROAD
CA
Enumeration date
06/08/2006
Last updated
03/07/2023
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