Provider Demographics
NPI:1184051385
Name:SHERLINEE, OBED GERALD (RN)
Entity type:Individual
Prefix:
First Name:OBED
Middle Name:GERALD
Last Name:SHERLINEE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4152 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1156
Mailing Address - Country:US
Mailing Address - Phone:619-987-3133
Mailing Address - Fax:
Practice Address - Street 1:4152 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1156
Practice Address - Country:US
Practice Address - Phone:619-987-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA749091163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine