Steven R. Shackford MD PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G29279 Issued in CA

Legal business name

STEVEN R. SHACKFORD MD PC

Practice address

550 Washington St.
Suite 641
San Diego, CA 92103-2229

Phone

(619) 299-2600

Fax

(619) 299-3923

NPI assigned

Aug 13, 2013

Organization subpart

No

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

Authorized official

Name

Steven R Shackford, MD PC

Title

Owner/President

Phone

(619) 299-2600

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1841623865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST.",
            "address_2": "SUITE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-299-2600",
            "fax_number": "619-299-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST.",
            "address_2": "SUITE 641",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032229",
            "telephone_number": "619-299-2600",
            "fax_number": "619-299-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R. SHACKFORD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "SHACKFORD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "619-299-2600",
        "authorized_official_credential": "MD PC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G29279",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G29279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven F Bucky PHD Apc
• Steven Giang OD, Inc.
• Steven P. James, M.D., Inc.
• Steven P. Theodosis Dental Corporation
• Steven R Drosman MD Inc
• Steven T Klein OD & Kimberly Plattner OD a Professional Corporation
• Steven T Klein OD & Kimberly Plattner OD a Professional Corporation
• Ariel Nicole Stevens, ASW
• Cody A Stevens
• Craig Andrew Stevens, PHARMD

• Vascular Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.