Healthcare Provider Details

I. General information

NPI: 1518991769
Provider Name (Legal Business Name): JOHN F SHEGA A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 HEALTH CENTER DR
SAN DIEGO CA
92123-2761
US

IV. Provider business mailing address

2710 HEALTH CENTER DR
SAN DIEGO CA
92123-2761
US

V. Phone/Fax

Practice location:
  • Phone: 858-292-7525
  • Fax:
Mailing address:
  • Phone: 858-292-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG40700
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberG40700
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN F SHEGA
Title or Position: MD
Credential: MD
Phone: 858-292-7525