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General NPI Number Information
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NPI Number | 1740255983
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Entity Type | Individual
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Provider Name | SHANNON LYNN HART D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 488 E VALLEY PKWY SUITE 310
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City | ESCONDIDO
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State | CA
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Zip | 92025-3363
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Country | US
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Telephone | 760-745-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 488 E VALLEY PKWY SUITE 310
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City | ESCONDIDO
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State | CA
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Zip | 92025-3363
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Country | US
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Telephone | 760-745-7060
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 02003006A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20A13012
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License Number State | CA
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