SHANON STAR MURILLO (NPI# 1104033018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104033018 |
| Entity Type | Individual |
| Full Name | SHANON STAR MURILLO |
| Other Name | SHANON STAR HEATON |
| Credential | PA-C |
| Practice Address |
2401 Reo Drive San Diego CA 92139 |
| Mailing Address |
1694 Gustavo Street El Cajon CA 92019 |
| Practice Telephone | 6194796767 |
| Practice Fax Number | 6194348840 |
| Mailing Telephone | 6192278228 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2010-02-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | P20292 | CA | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | 001546 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004235900 | 05 |
| Street Address |
2401 REO DRIVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831621689 | Paige Tetreau | Prevention Professional | 2367 Morningside St, San Diego, CA 92139 | 2017-03-31 |
| 1881030310 | Brandon Christopher Jackson | Military Health Care Provider | 6810 Camphor Ln, San Diego, CA 92139 | 2013-05-10 |
| 1720316532 | Jacobi Medical Center | General Acute Care Hospital | 6861 Potomac Street, 57, San Diego, CA 92139 | 2009-12-07 |
| 1083862296 | Jennie C Bilbes | Registered Nurse | 6860 Bear Rier Row, Unit #1, San Diego, CA 92139 | 2008-08-29 |
| 1851378236 | Iyabo O Daramola | Internal Medicine | 2401 Reo Dr, San Diego, CA 92139 | 2005-12-28 |
| 1770180648 | Darius Lee Sean Woods | Military Health Care Provider | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 |
| 1134580913 | Emilio Casenave | Military Health Care Provider | 6031 Sandy Shore Ct, San Diego, CA 92139-1014 | 2016-03-08 |
| 1689934879 | Neil Allen Regero Nucup | Military Health Care Provider | 1802 Rocky Shore Rd, San Diego, CA 92139-1017 | 2012-05-21 |
| 1568855880 | Jameson Basa | Military Health Care Provider | 1976 Sky Harbor Rd, San Diego, CA 92139-1023 | 2015-03-11 |
| 1558798918 | Jesse Lee Reed | Military Health Care Provider | 6016 Rock Island Rd, San Diego, CA 92139-1030 | 2013-10-01 |
| Find all providers in zip 92139 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233645 | Svr Medical PC | Internal Medicine | 4440 Euclid Ave Ste E, San Diego, CA 92115-4522 | 2020-07-30 |
| 1023639176 | Arthur Wong | Internal Medicine | 4222 Kansas St Unit 2, San Diego, CA 92104-1802 | 2020-04-29 |
| 1679102461 | Santosh Vetticaden | Internal Medicine | 6420 Mesa Norte Dr, San Diego, CA 92130-6852 | 2020-04-03 |
| 1225664964 | Andres Smith M.d. A Professional Medical Corporation | Internal Medicine | 6244 El Cajon Blvd Ste 29, San Diego, CA 92115-3918 | 2020-03-13 |
| 1154972388 | Kimberly Hall Fernandez | Internal Medicine | 700 W E St Unit 2101, San Diego, CA 92101-5993 | 2019-09-29 |
| 1992289300 | Sd Healthcare Solutions | Internal Medicine | 5943 Thorn St, San Diego, CA 92105-3916 | 2018-09-21 |
| 1992295331 | Alera Inc | Internal Medicine | 2667 Camino Del Rio S Ste 307-6, San Diego, CA 92108 | 2018-05-11 |
| 1275020844 | Lf Capital Inc | Internal Medicine | 438 Camino Del Rio S Ste 203, San Diego, CA 92108-3546 | 2018-04-18 |
| 1710401302 | Ca Post Acute Specialists PC | Internal Medicine | 3525 Del Mar Heights Rd # 966, San Diego, CA 92130-2199 | 2017-07-26 |
| 1063933604 | John Jackson Howard | Internal Medicine | 4616 Patricia Pl, San Diego, CA 92115-1934 | 2017-07-05 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.