Sullivan, Shannon

Sullivan, Shannon is an individual health care provider with primary practice located at 450 Broadway St Mail Code 5704, Redwood City CA 94063-3132. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Pulmonology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Sullivan, Shannon can be contacted via phone (650) 723-6601.

Contact Information

Primary practice address
450 Broadway St Mail Code 5704 Redwood City CA 94063-3132
Phone: (650) 723-6601
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A81983 California
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X A81983 California
Allopathic & Osteopathic Physicians / Sleep Medicine 2080S0012X A81983 California

Profile Details

NPI number 1861515231
LBN Legal business name Sullivan, Shannon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2007
Last updated Apr 18th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861515231 NPPES
California Other A81983 CA MEDICAL LICENSE

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