MEDICARE: PATRICK EDWARD SHIPSEY 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
1	207P00000X	Emergency Medicine Physician	G86616	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821167545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK EDWARD SHIPSEY M.D.

Provider Business Mailing Address
First Line	:	2140 CAL YOUNG RD
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-2043
Country	:	US
Telephone Number	:	661-496-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 N CALIFORNIA BLVD
Second Line	:	SUITE 400
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-3742
Country	:	US
Telephone Number	:	925-225-5837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/25/2013

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