Stanley, Shayne Tyler
Stanley, Shayne Tyler is an individual health care provider with primary practice located at 2600 Dodson St Ste 3 , Port Hueneme CA 93043-4432. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Stanley, Shayne Tyler can be contacted via phone (661) 794-0954.Contact Information
Primary practice address
2600 Dodson St Ste 3
Port Hueneme CA 93043-4432
Phone: (661) 794-0954
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1275007791 |
|---|---|
| LBN Legal business name | Stanley, Shayne Tyler |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2019 |
| Last updated | Jan 17th, 2019 - about 5 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 | 1275007791 | NPPES |
| California | Other | D9195737 | DRIVER LICENSE |
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