Basic Information
| Provider Information | |||||||||
| NPI: | 1033189634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHIELD | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | FREDERICK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16280 STINE CT | ||||||||
| Address2: | |||||||||
| City: | SONORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953708124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095334918 | ||||||||
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| Practice Location | |||||||||
| Address1: | 690 GUZZI LN | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SONORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953705289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095365070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 10/22/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | G45205 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.