Provider Demographics
NPI:1154301596
Name:SHEARER, DONALD E (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:SHEARER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-0730
Mailing Address - Country:US
Mailing Address - Phone:909-796-0101
Mailing Address - Fax:909-796-3035
Practice Address - Street 1:11346 MOUNTAIN VIEW AVE
Practice Address - Street 2:STE B
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3833
Practice Address - Country:US
Practice Address - Phone:909-796-0101
Practice Address - Fax:909-796-3035
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG22378207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G22378Medicaid
CAG22378Medicare ID - Type Unspecified
CA00G22378Medicaid