| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHANE ASHBAUGH | 1821635467 | 2020-07-29 |
Shane D Ashbaugh [M] graduated in 2020 and primarily specializes in Physician Assistant.
Shane Ashbaugh is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1821635467. Registration indicates Shane Ashbaugh is a provider of services with a specialization in Technologists, Technicians & Other Technical Service Providers, Specialist/Technologist, Other (Specialist/Technologist, Other: Certified First Assistant, ) (All Other Specialties & Provider Types, ) (Specialist/Technologist, Other Surgical Assistant, Technologists, Technicians & Other Technical Service Providers) (Specialist/Technologist, Other, ) (Technologists, Technicians & Other Technical Service Providers, Specialist/Technologist, Other) (Specialist/Technologist, Other Orthopedic Assistant, Technologists, Technicians & Other Technical Service Providers) (Specialist/Technologist, Other, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| PECOS ID | 1153747761 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Shane Ashbaugh |
| Practice Office Address | 38690 STIVERS ST STE A FREMONT, CA US |
| Practice Office Telephone | 5102481040 |
| Mailing Address | 38690 STIVERS ST STE A FREMONT, CA 945365276 US |
| Business Telephone | 5102481040 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2327 Armada Way | San Mateo, CA 944041526 | 9195246167 |
| Code | Practice | License No State |
|---|---|---|
| 246ZC0007X | Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other Specialist/Technologist, Other: Certified First Assistant All Other Specialties & Provider Types Specialist/Technologist, Other Surgical Assistant Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other | |
| 246ZX2200X | Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other Specialist/Technologist, Other Orthopedic Assistant Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other | |
| 363AS0400X PRIMARY | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | 58356
CA |