Provider Demographics
NPI:1598913071
Name:SHIPP, BYRON (RRT)
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:
Last Name:SHIPP
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 CLARINADA AVE
Mailing Address - Street 2:APT 14
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4080
Mailing Address - Country:US
Mailing Address - Phone:650-991-2487
Mailing Address - Fax:
Practice Address - Street 1:586 CLARINADA AVE
Practice Address - Street 2:APT 14
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4080
Practice Address - Country:US
Practice Address - Phone:650-991-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00023178227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered