Most Relevant Information
Provider Data
| NPI Number: | 1003429929 |
| Provider Name: | SHANNON BUCKLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/29/2020 |
| Last Updated: | 06/01/2022 |
Provider Practice Location
5655 DOROTHY WAY
SAN DIEGO
CA
921152308
Practice Location Phone/Fax
| Phone: | 4158859444 |
| Fax: |
Provider Mailing Location
200 SANTA PAULA AVE
SAN FRANCISCO
CA
941271526
Provider Mailing Phone/Fax
| Phone: | 4158859444 |
| Fax: |