Dr. Shayne Poulin M.D.

NPI 1184915407

Information of Dr. Shayne Poulin M.D.

The NPI 1184915407 is an Individual type. NPI No 1184915407 belongs to Shayne Poulin. Dr. Shayne Poulin M.D. specializes in Family Medicine. She is practising at 1873 Commercenter W, San Bernardino, California 92408. You can also contact him via phone number (909) 890-5511.

Practice address located

  • 1873 Commercenter W
  • San Bernardino, California 92408
  • (909) 890-5511
  • (909) 890-5511

Mailling address located

  • 700 S Tustin St
  • Orange, California 92866
  • (714) 922-4100
  • (866) 886-7824
Dr. Shayne Poulin M.D. is PECOS enrolled.
NPI No 1184915407
Primary Taxonomy
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
Yes207Q00000XFamily Medicine146174California
No207Q00000XFamily Medicine260709Massachusetts
Identifier for this provider
StateIdentifierTypeIssuer
MA110097301AMedicaidn/a
MAS400169975Medicare PINn/a
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