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General NPI Number Information
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NPI Number | 1275560484
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Entity Type | Individual
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Provider Name | DAVID FREDERICK SHIRLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3031 STANFORD RANCH RD SUITE 2, #220
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City | ROCKLIN
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State | CA
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Zip | 95765-5554
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Country | US
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Telephone | 916-677-7962
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Fax | 916-435-2964
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Provider Business Mailing Address
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Address Line | 3031 STANFORD RANCH RD SUITE 2, #220
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City | ROCKLIN
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State | CA
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Zip | 95765-5554
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Country | US
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Telephone | 916-677-7962
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Fax | 916-435-2964
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | G66004
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License Number State | CA
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