Shough, Charlene G
Shough, Charlene G is an individual health care provider with primary practice located at 751 S Bascom Ave Pediatrics Dept, San Jose CA 95128-2604. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is her primary health care specialty. Shough, Charlene G can be contacted via phone (408) 885-5630.Contact Information
Primary practice address
751 S Bascom Ave Pediatrics Dept
San Jose CA 95128-2604
Phone: (408) 885-5630
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | G25692 | California |
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | G25692 | California |
| Allopathic & Osteopathic Physicians / Pediatric Endocrinology | 2080P0205X | G25692 | California |
Profile Details
| NPI number | 1629173224 |
|---|---|
| LBN Legal business name | Shough, Charlene G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Sep 12th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629173224 | NPPES |
| California | MEDICAID | 00G256920 |
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