Provider Demographics
NPI:1154516490
Name:SHIFFMAN, ADAM HOWARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:HOWARD
Last Name:SHIFFMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:ATTN: CREDENTIALING/PAYER ENROLLMENT
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4598 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112
Practice Address - Country:US
Practice Address - Phone:415-965-7941
Practice Address - Fax:415-965-7935
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2018-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002612363A00000X
CAPA21014363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant