Kevin C Shannon (NPI# 1356470314, PAC ID# 3072544782) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1356470314 |
| PAC ID by PECOS | 3072544782 |
| Professional Enrollment ID | I20120821000322 |
| Full Name | Kevin C Shannon |
| Organization Legal Name | SAC HEALTH SYSTEM |
| Address |
1454 E 2nd St San Bernardino CA 92408-0118 |
| Phone Number | 9093827100 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1985 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4385533579 |
| Number of Group Practice Members | 116 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050327 | LOMA LINDA UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1454 E 2nd St, San Bernardino, CA 92408-0118 | 9093827100 | SAC HEALTH SYSTEM |
| 250 S G St, San Bernardino, CA 92410-3320 | 9093827100 | SAC HEALTH SYSTEM |
| Organization Legal Name | SAC HEALTH SYSTEM |
| Physicians | 29 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Samano | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Douglas R Hegstad | Hospitalist | Sac Health System | 250 S G St, San Bernardino, CA 92410-3320 |
| Brenda J Boyle | Nurse Practitioner | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Roger D Woodruff | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Alma M Palisoc | Preventative Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Maria Lohr | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Catherine Jl Kelly | Psychologist, Clinical | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Ann D Curtis | Clinical Social Worker | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Jennifer Li | Hospitalist | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Janel L Calinisan | Psychologist, Clinical | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Street Address |
1454 E 2ND ST |
| City | SAN BERNARDINO |
| State | CA |
| Zip | 92408-0118 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Samano | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Brenda J Boyle | Nurse Practitioner | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Roger D Woodruff | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Alma M Palisoc | Preventative Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Maria Lohr | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Catherine Jl Kelly | Psychologist, Clinical | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Ann D Curtis | Clinical Social Worker | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Jennifer Li | Hospitalist | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Janel L Calinisan | Psychologist, Clinical | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Christen Leah Cuevas | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bonnie I Chi Lum | Preventative Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Harvey A Elder | Internal Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Van T Nguyen | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Jason Lohr | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Mai-linh Ngoc Tran | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Randy Michael Stinnett | Psychologist, Clinical | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| David Ahamba | Family Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Kenneth W Hart | Preventative Medicine | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Hang T Lee | Nurse Practitioner | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Sonia Guilfoos | Clinical Social Worker | Sac Health System | 1454 E 2nd St, San Bernardino, CA 92408-0118 |
| Find all physicians in zip 92408 | |||
| City | SAN BERNARDINO |
| Zip Code | 92408 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SAN BERNARDINO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Kevin C Shannon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.