Provider Demographics
NPI:1407173149
Name:KOURA, SHAWN SINGH (MD)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:SINGH
Last Name:KOURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3456 CAMINO DEL RIO N
Mailing Address - Street 2:STE 207
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1715
Mailing Address - Country:US
Mailing Address - Phone:877-256-2043
Mailing Address - Fax:800-852-5826
Practice Address - Street 1:751 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6617
Practice Address - Country:US
Practice Address - Phone:877-256-2043
Practice Address - Fax:800-852-5826
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA125775207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program