John Shackelford Lane III MD

NPI 1043390172 - Surgery - 2086S0129X

NPI Details
NPI 1043390172
Gender Male
Enumeration Date 10/16/2006
Last Updated 04/04/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
200 W ARBOR DR
MAILCODE 7403
SAN DIEGO CA, 92103-9000, US
Phone (858) 657-7404
Fax (858) 657-5033
Business Location
200 WEST ARBOR DRIVE
MAILCODE 7403
SAN DIEGO CA, 92103-7403, US
Phone (858) 657-7404
Fax (858) 657-5033
Toxanomy
Taxonomy Code 2086S0129X
License State California
License Number 000000G81602
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According to our database, Dr. John Shackelford Lane III MD NPI is 1043390172, taxonomy code is 2086S0129X and license number is 000000G81602, license state is located at California. John Shackelford Lane III MD physically located at 200 W Arbor Dr, San Diego CA, 92103-9000. NPI Number John Shackelford Lane III MD has the Individual type.

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1043390172 NPI number is provided on an as is basis without warranty of any kind. 1043390172 is maintained by the National Plan & Provider Enumeration System. The contents of John Shackelford Lane III MD are for informational purposes only.