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General NPI Number Information
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NPI Number | 1649460569
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Entity Type | Organization
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Legal Business Name | CARING NEUROLOGY SERVICES MEDICAL CLINIC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 17150 EUCLID STREET SUITE 320
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-432-1321
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Fax | 714-434-1890
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Provider Business Mailing Address
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Address Line | 17150 EUCLID STREET SUITE 320
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-432-1321
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Fax | 714-434-1890
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT L SHOEMAKER
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Credential |
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Telephone | 714-432-1321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | G71964
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License Number State | CA
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