Healthcare Provider Details

I. General information

NPI: 1306800339
Provider Name (Legal Business Name): DAVID V. SHATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD. MH 4206 UC DAVIS MEDICAL CENTER - DIVISION OF TRAUMA
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2315 STOCKTON BLVD., MH 4206 UC DAVIS MEDICAL CENTER - DIVISION OF TRAUMA
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3950
  • Fax: 916-734-7755
Mailing address:
  • Phone: 916-734-3950
  • Fax: 916-734-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberME62857
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number88378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: