DR. SAM SHIESHA MD FAAFP NPI 1316046253

NPI Information

NPI: 1316046253
Provider Name: DR. SAM SHIESHA, MD, FAAFP
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

Address:
25101 BEAR VALLEY RD
PMB 347
TEHACHAPI, CA
ZIP 93561
Phone: (661) 335-2891
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DR. Sam Shiesha, MD, FAAFP is an adult medicine family medicine in Tehachapi, CA. The provider is definition to come. DR. Sam Shiesha, MD, FAAFP NPI is 1316046253. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

25101 BEAR VALLEY RD
PMB 347
TEHACHAPI, CA
ZIP 93561-311
Phone: (661) 335-2891

The enumeration date for this NPI number is 9/21/2006 and was last updated on 10/20/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0000X	Family Medicine	Adolescent Medicine	A46051	CALIFORNIA	No
2	207QA0505X	Family Medicine	Adult Medicine	A46051	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A460510	MEDICAID	CALIFORNIA
2	WA46051C	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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