Shane Ashbaugh
Physician Assistant, Surgical in Fremont, CA. Individual provider (NPI-1).
NPI number1821635467
StatusActive
Last updated in NPPESJul 29, 2020
Details
- NPI
- 1821635467
- Entity type
- Individual (NPI-1)
- Name
- Shane Ashbaugh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 3, 2019
- Certification date
- Jul 29, 2020
- Last updated
- Jul 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 58356 | CA | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | – | – | |
| 246ZX2200X | Specialist/Technologist, Other, Orthopedic Assistant | – | – |
Practice location
38690 Stivers St Ste AFremont, CA 94536-5276
Phone 510-248-1040
Mailing address
38690 Stivers St Ste AFremont, CA 94536-5276
Phone 510-248-1040
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