Dylan Shackelford

NPI 1063179562 · on the registry since 2021

Practice

Address: 1704 Miramonte Ave Ste 3
Mountain View, CA 94040
Phone: (650) 930-9550
Organisation at this address: Ray C. Kuo, Dmd, Inc.
Intervention Center For Autism Needs
Midori Nishimura M D Ibclc Family Medicine And Lactation Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 88

Registry record

Primary taxonomy: 106S00000X
106S00000X
Licence states on file: NULL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2021-11-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California