Individual provider · Type 1 NPI

Shane A. Futchko, PA-C

Medical Physician Assistant · San Diego, CA

NPI number 1639357676 Active

Practice location

3930 4th Ave, Ste 200
San Diego, CA 92103-3119

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA21690 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1639357676

Shane A. Futchko, PA-C's National Provider Identifier is 1639357676, issued on Feb 1, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in San Diego, CA. The record was last updated on Jul 27, 2012.