MEDICARE: CATHERINE RUTH SHEILS MD

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	207W00000X	Ophthalmology Physician	A165389	CA

General Provider Information

NPI Number	:	1932605649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE RUTH SHEILS MD

Provider Business Mailing Address
First Line	:	555 N 13TH AVE
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91786-4904
Country	:	US
Telephone Number	:	800-345-8979
Fax Number	:	909-949-3967

Provider Business Practice Location Address
First Line	:	5330 CARROLL CANYON RD STE 210
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3758
Country	:	US
Telephone Number	:	800-345-8979
Fax Number	:	909-949-3967

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

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	07/14/2023

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