Provider Demographics
NPI:1912272733
Name:ADAN, SHEILA MARIE ADAYA (DO)
Entity Type:Individual
Prefix:DR
First Name:SHEILA MARIE
Middle Name:ADAYA
Last Name:ADAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:ADAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2295 S VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7925
Mailing Address - Country:US
Mailing Address - Phone:909-724-5000
Mailing Address - Fax:909-724-2526
Practice Address - Street 1:2295 S VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-7925
Practice Address - Country:US
Practice Address - Phone:909-724-5000
Practice Address - Fax:909-724-2526
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12266207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine