Provider Demographics
NPI:1972896157
Name:SHEPHERD, PATRICK CHAD (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHAD
Last Name:SHEPHERD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 W AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2814
Mailing Address - Country:US
Mailing Address - Phone:661-949-5355
Mailing Address - Fax:661-949-5196
Practice Address - Street 1:1600 W AVENUE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2814
Practice Address - Country:US
Practice Address - Phone:661-949-5355
Practice Address - Fax:661-949-5196
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1306592080P0205X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology