Provider Demographics
NPI:1609296763
Name:SHAKED, OREN (MD)
Entity Type:Individual
Prefix:
First Name:OREN
Middle Name:
Last Name:SHAKED
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 1:513 PARNASSUS AVE
Mailing Address - Street 2:UCSF - DEPARTMENT OF SURGERY, S-321
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:513 PARNASSUS AVE RM S-321
Practice Address - Street 2:UCSF - DEPARTMENT OF SURGERY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0470
Practice Address - Country:US
Practice Address - Phone:415-476-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA139699208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery