| Doctor Name: | AMY SHANK |
| NPI Number: | 1548586993 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 572910 |
| Business Practice Address: | 18945 Fm 2252 Garden Ridge, TX - 782662562 |
| Business Phone Number: | 2106510027 |
| Business Fax Number: | |
| Mailing Address: | 26020 Avenida Del Oro, TEMECULA |
| State: | CA |
| Postal Code: | 925903977 |
| Phone Number: | 9515063895 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2010 |
| NPI Last Update Date: | 04/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | 572910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |