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General NPI Number Information
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NPI Number | 1073527198
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Entity Type | Individual
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Provider Name | PERRY MICHAEL SHOOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 1303 SAN CARLOS AVE
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City | SAN CARLOS
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State | CA
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Zip | 94070-2317
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Country | US
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Telephone | 650-593-0965
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Fax | 650-593-2379
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Provider Business Mailing Address
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Address Line | 80 SUTHERLAND DR
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City | ATHERTON
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State | CA
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Zip | 94027-6430
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Country | US
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Telephone | 650-854-3578
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Fax | 650-854-3643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | G24044
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G24044
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License Number State | CA
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