MEDICARE: L. RICHARD SHEARER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	G37221	CA

General Provider Information

NPI Number	:	1144406711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	L. RICHARD SHEARER M.D.

Provider Business Mailing Address
First Line	:	701 PINE ST
Second Line	:
City	:	MOUNT SHASTA
State	:	CA
Zip	:	96067-2133
Country	:	US
Telephone Number	:	530-926-6222
Fax Number	:	530-926-0444

Provider Business Practice Location Address
First Line	:	701 PINE ST
Second Line	:
City	:	MOUNT SHASTA
State	:	CA
Zip	:	96067-2133
Country	:	US
Telephone Number	:	530-926-6222
Fax Number	:	530-926-0444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	07/05/2012

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