Brenda M. Shank, MD, PHD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

G44045 Issued in CA

Practice address

2000 Vale Rd
Doctors Medical Center
San Pablo, CA 94806-3808

Phone

(510) 970-5667

Fax

(510) 970-5743

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1710037536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VALE RD",
            "address_2": "DOCTORS MEDICAL CENTER",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063808",
            "telephone_number": "510-970-5667",
            "fax_number": "510-970-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VALE RD",
            "address_2": "DOCTORS MEDICAL CENTER",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063808",
            "telephone_number": "510-970-5667",
            "fax_number": "510-970-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "BRENDA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G44045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G440450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seneca Family of Agencies
• Joselyn Serrano Gutierrez
• Dominie Estandian Serrano, RPH
• Don Lyle Severn, CI21700218 (CADC 1 )
• Alaafia Faremi Shannon Shambe
• Radhika Rani Sharma
• Vinod Sharma, M.D.
• Sharon B. Drager, MD, Professional Corporation
• Michael R Shaub, DC
• Stephanie J Shaw-Perry

• Radiation Oncology Physician in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.