Basic Information
| Provider Information | |||||||||
| NPI: | 1346286580 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHANFIELD | ||||||||
| FirstName: | STEWART | ||||||||
| MiddleName: | LLOYD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2141 N HARBOR BLVD STE 35000 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146268630 | ||||||||
| FaxNumber: | 7146268659 | ||||||||
| Practice Location | |||||||||
| Address1: | 2141 N HARBOR BLVD | ||||||||
| Address2: | SUITE 35000 | ||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146268630 | ||||||||
| FaxNumber: | 7146268659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G45883 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 174400000X | G45883 | CA | N | Other Service Providers | Specialist |
No ID Information.