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Individual

DEBORAH A SHASSETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1144 COFFEE RD, MODESTO, CA 95355-4205
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20A7171
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX71710
CA
Enumeration date
05/05/2006
Last updated
02/03/2011
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