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General NPI Number Information
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NPI Number | 1790877785
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Entity Type | Organization
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Legal Business Name | SANDRA J. SHETZLINE, DO INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2740 HIGHWAY 4 DRAWER V
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City | ARNOLD
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State | CA
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Zip | 95223
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Country | US
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Telephone | 209-795-4488
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Fax | 209-794-0984
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Provider Business Mailing Address
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Address Line | 602 SHEEP RANCH RD
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City | MURPHYS
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State | CA
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Zip | 95247-9705
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Country | US
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Telephone | 209-795-4488
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Fax | 209-795-0984
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA JEAN SHETZLINE
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Credential | D.O.
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Telephone | 209-795-4488
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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 | 20A7319
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License Number State | CA
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