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General NPI Number Information
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NPI Number | 1386102952
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Entity Type | Individual
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Provider Name | SHAUN OSTROFE DO
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Gender | Male
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Dates
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Enumeration Date | 03/03/2019
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE
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City | SAN DIEGO
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State | CA
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Zip | 92134-2111
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Country | US
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Telephone | 619-532-9684
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Fax |
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Provider Business Mailing Address
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Address Line | 1395 CAMINITO FLOREO
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City | LA JOLLA
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State | CA
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Zip | 92037-7188
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Country | US
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Telephone | 208-720-9861
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0102206354
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License Number State | VA
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