Provider Demographics
NPI:1811181092
Name:SHOBHA SEKHON MD
Entity type:Organization
Organization Name:SHOBHA SEKHON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUEMAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-674-8787
Mailing Address - Street 1:820 E ALMOND AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5603
Mailing Address - Country:US
Mailing Address - Phone:559-674-8787
Mailing Address - Fax:559-674-3592
Practice Address - Street 1:820 E ALMOND AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5603
Practice Address - Country:US
Practice Address - Phone:559-674-8787
Practice Address - Fax:559-674-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43774174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ22728ZMedicare PIN