Provider Demographics
NPI:1821167545
Name:SHIPSEY, PATRICK EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:EDWARD
Last Name:SHIPSEY
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 1:2140 CAL YOUNG RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2043
Mailing Address - Country:US
Mailing Address - Phone:661-496-6500
Mailing Address - Fax:
Practice Address - Street 1:1990 N CALIFORNIA BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3742
Practice Address - Country:US
Practice Address - Phone:925-225-5837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86616207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G866160Medicaid
CA00G866160Medicare ID - Type Unspecified
CA00G866160Medicaid