Provider Demographics
NPI:1306106737
Name:SHELDON J. NANKIN, M.D. INC.
Entity type:Organization
Organization Name:SHELDON J. NANKIN, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC OPHTHALMOLGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:J
Authorized Official - Last Name:.NANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-997-2020
Mailing Address - Street 1:1310 W. STEWART DR.
Mailing Address - Street 2:SUITE 504
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 W. STEWART DR.
Practice Address - Street 2:SUITE 504
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-997-2020
Practice Address - Fax:714-997-0322
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHELDON J. NANKIN, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG17825208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty