Organization
DENNIS D SHEPARD MD INC
Active
Other names
Shepard Eye Center Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS SHEPARD MD (PRESIDENT)
(805) 614-7005
Entity
Organization
Contact information
Practice address
1418 E MAIN ST, STE 110, SANTA MARIA, CA 93454
(805) 614-7005
(805) 614-7006
Mailing address
1418 E MAIN ST, STE 110, SANTA MARIA, CA 93454
(805) 614-7005
(805) 614-7006
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
050000322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR01010F
—
CA
01
—
ZZZH4200Z
BLUE SHIELD OF CA
CA
Enumeration date
05/02/2006
Last updated
04/24/2008
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