Individual
MATTHEW SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-4939
Mailing address
9681 HILLSIDE RD, ALTA LOMA, CA 91737-4919
(909) 581-2461
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3960
CA
Other
Enumeration date
05/20/2010
Last updated
12/10/2021
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