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NPI Code Detail

MEDICARE: LYNN P SHIPMAN M.D.

MEDICARE: LYNN P SHIPMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG52015CA

General Provider Information

NPI Number : 1770582306
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN P SHIPMAN M.D.
Provider Business Mailing Address
First Line : 2218 VIA TESORO
Second Line :
City : ALPINE
State : CA
Zip : 91901-3162
Country : US
Telephone Number : 858-451-3311
Fax Number : 858-451-1142
Provider Business Practice Location Address
First Line : 15525 POMERADO RD
Second Line : SUITE A-2
City : POWAY
State : CA
Zip : 92064-2435
Country : US
Telephone Number : 858-451-3311
Fax Number : 858-451-1142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 07/15/2010

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