Healthcare Provider Details

I. General information

NPI: 1124099130
Provider Name (Legal Business Name): SHEILA A CASON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA A SMITH

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26900 NEWPORT RD SUITE 111
MENIFEE CA
92584-9222
US

IV. Provider business mailing address

27699 JEFFERSON AVE SUITE 300
TEMECULA CA
92590-2661
US

V. Phone/Fax

Practice location:
  • Phone: 951-301-5380
  • Fax: 951-301-5390
Mailing address:
  • Phone: 951-252-8588
  • Fax: 951-252-8589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA86423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: