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General NPI Number Information
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NPI Number | 1376717025
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Entity Type | Organization
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Legal Business Name | J. ANTHONY SHAHEEN MD INC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 910 MAJOR SHERMAN LN STE 205
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City | MONTEREY
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State | CA
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Zip | 93940-4642
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Country | US
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Telephone | 831-373-3600
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Fax | 831-373-0686
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Provider Business Mailing Address
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Address Line | 910 MAJOR SHERMAN LN SUITE 205
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City | MONTEREY
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State | CA
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Zip | 93940-4642
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Country | US
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Telephone | 831-373-3600
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Fax | 831-373-0686
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Authorized Official
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Title or Position | OWNER/OFFICER
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Name | DR. JOHN ANTHONY SHAHEEN
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Credential | MD
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Telephone | 831-917-1785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | G77558
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G783340
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License Number State | CA
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