Provider Demographics
NPI:1114997434
Name:SHAHEEN, RAYMOND MICHAEL I (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:MICHAEL
Last Name:SHAHEEN
Suffix:I
Gender:M
Credentials:MD, FACS
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Mailing Address - Street 1:305 SOUTH DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4200
Mailing Address - Country:US
Mailing Address - Phone:650-965-1909
Mailing Address - Fax:650-965-1944
Practice Address - Street 1:305 SOUTH DR
Practice Address - Street 2:SUITE 7
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4200
Practice Address - Country:US
Practice Address - Phone:650-965-1909
Practice Address - Fax:650-965-1944
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-12-14
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Provider Licenses
StateLicense IDTaxonomies
CAA630712086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG88764Medicare UPIN