O. HOWARD SHATTUCK P.A. NPI 1568569598

NPI Information

NPI: 1568569598
Provider Name: O. HOWARD SHATTUCK, P.A.
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
11370 ANDERSON ST
STE 2100
LOMA LINDA, CA
ZIP 92354
Phone: (909) 558-2822
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O. Howard Shattuck, P.A. is a surgical physician assistant in Loma Linda, CA. O. Howard Shattuck, P.A. NPI is 1568569598. 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:

11370 ANDERSON ST
STE 2100
LOMA LINDA, CA
ZIP 92354-450
Phone: (909) 558-2822

The NPI 1568569598 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 9/24/2007.

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	363AS0400X	Physician Assistant	Surgical	PA10544	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	0PA105440	MEDICARE PIN	CALIFORNIA
2	R22413	MEDICARE UPIN

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: 4/28/2024

NPI Synchronization or Removal

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