Charlene G Shough in San Jose - Developmental - Behavioral Pediatrics
Charlene G Shough - NPI 1629173224
Charlene G Shough is a Developmental - Behavioral Pediatrics in San Jose, California. Charlene G Shough practices all healthcare services and medical treatments related to Developmental - Behavioral Pediatrics. The NPI Number for Charlene G Shough is 1629173224. The last update date is 2007-09-12.
Charlene G Shough's current location address is 751 S Bascom Ave, San Jose, California. You can contact this provider via phone number 4088855630. The mailing address for Charlene G Shough is 751 S Bascom Ave, San Jose, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charlene G Shough |
|---|---|
| Address | 751 S Bascom Ave, San Jose, California |
| Phone Number | 4088855630 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1629173224 |
|---|---|
| Provider Enumeration Date | 2006-09-14 |
| Last Updated Date | 2007-09-12 |
Provider Mailing Address Detail
| Address | 751 S Bascom Ave |
|---|---|
| City | San Jose |
| State | California (CA) |
| Post Code | 951282604 |
| Phone Number | 4088855630 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Developmental - Behavioral Pediatrics |
|---|---|
| Taxonomy | 2080P0006X |
| Licence No | G25692 |
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Definition: A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy effort |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00G256920 | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Charlene G Shough by the Centers for Medicare & Medicaid Services?
The Charlene G Shough has been assigned the NPI (National Provider Identifier) 1629173224. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Charlene G Shough is located?
The Charlene G Shough is situated at the following address: 751 S Bascom Ave, San Jose, CA, 951282604.
What is the Charlene G Shough's specialty and taxonomy code?
The Charlene G Shough's specialty is Developmental - Behavioral Pediatrics, and the corresponding taxonomy code is 2080P0006X.
When did the Charlene G Shough receive its 1629173224?
The Charlene G Shough was issued its 1629173224 on 2006-09-14, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Charlene G Shough last refreshed?
The information related to the Charlene G Shough, including its address, specialty, and other relevant details, was last updated on 2007-09-12.
NPI Number: 1932102142
Address: St. Jude Children's Research Hospital, Memphis, TN