Individual
SHANE ASHBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
38690 STIVERS ST STE A, FREMONT, CA 94536-5276
(510) 248-1040
Mailing address
38690 STIVERS ST STE A, FREMONT, CA 94536-5276
(510) 248-1040
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
246ZX2200X
Orthopedic Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
58356
CA
Other
Enumeration date
12/03/2019
Last updated
07/29/2020
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