Healthcare Provider Details

I. General information

NPI: 1477574572
Provider Name (Legal Business Name): STUART B SHIKORA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 EAST ST
CONCORD CA
94520-1906
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-8200
  • Fax:
Mailing address:
  • Phone: 925-756-3499
  • Fax: 925-757-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG42847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: