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NPI Code Detail

MEDICARE: DR. SHATHA F MECHAEL DDS

MEDICARE: DR. SHATHA F MECHAEL DDS
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
11223G0001XGeneral Practice Dentistry47950CA

General Provider Information

NPI Number : 1174620348
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHATHA F MECHAEL DDS
Provider Business Mailing Address
First Line : 2720 FLETCHER PKWY
Second Line :
City : EL CAJON
State : CA
Zip : 92020-2110
Country : US
Telephone Number : 619-466-1292
Fax Number : 619-466-2056
Provider Business Practice Location Address
First Line : 2720 FLETCHER PKWY
Second Line :
City : EL CAJON
State : CA
Zip : 92020-2110
Country : US
Telephone Number : 619-466-1292
Fax Number : 619-466-2056
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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