Provider Demographics
NPI:1386887974
Name:ROSEN, SHAWN D (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:D
Last Name:ROSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2108 WILMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6239
Mailing Address - Country:US
Mailing Address - Phone:925-363-0069
Mailing Address - Fax:925-363-0077
Practice Address - Street 1:1 COUNTRY CLUB PLZ
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2308
Practice Address - Country:US
Practice Address - Phone:925-254-3805
Practice Address - Fax:925-254-9783
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-12
Last Update Date:2023-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI56266-20207R00000X
CAA125206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine