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General NPI Number Information
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NPI Number | 1467778456
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Entity Type | Individual
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Provider Name | JULIA ANN SHRIVASTAVA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 12395 EL CAMINO REAL SUITE 120
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City | SAN DIEGO
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State | CA
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Zip | 92130-3082
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Country | US
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Telephone | 858-793-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 12395 EL CAMINO REAL SUITE 120
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City | SAN DIEGO
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State | CA
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Zip | 92130-3082
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Country | US
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Telephone | 858-793-2727
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33085
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62453
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.143937
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A125301
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 67429-20
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101261770
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2017016675
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License Number State | MO
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10387259-1205
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License Number State | UT
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