Otis, Shirley M.
Otis, Shirley M. is an individual health care provider with primary practice located at 10666 N Torrey Pines Rd , La Jolla CA 92037-1027. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Otis, Shirley M. can be contacted via phone (858) 554-8892.Contact Information
Primary practice address
10666 N Torrey Pines Rd
La Jolla CA 92037-1027
Phone: (858) 554-8892
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G14706 | California |
Profile Details
| NPI number | 1568424661 |
|---|---|
| LBN Legal business name | Otis, Shirley M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2006 |
| Last updated | Jun 26th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568424661 | NPPES |
| Other | 340005983 | RAILROAD MEDICARE | |
| Other | F020 | RAILROAD MEDICARE | |
| MEDICAID | 00G147060 | RAILROAD MEDICARE |
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