Provider Demographics
NPI:1639336050
Name:PRIBYL, SHEA M (DO)
Entity type:Individual
Prefix:DR
First Name:SHEA
Middle Name:M
Last Name:PRIBYL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:101 BODIN CIR
Mailing Address - Street 2:60 MDG/SGCH
Mailing Address - City:TRAVIS AFB
Mailing Address - State:CA
Mailing Address - Zip Code:94535-1809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2906
Practice Address - Country:US
Practice Address - Phone:707-257-4083
Practice Address - Fax:707-257-4168
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2024-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036134308208G00000X
MS21271208G00000X
CA20A14720208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)