| Shannon L Cornwell, PA | |
|
101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835-3809 | |
| (714) 992-3965 | |
| Not Available |
| Full Name | Shannon L Cornwell |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 101 E Valencia Mesa Dr, Fullerton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902961626 | NPI | - | NPPES |
| WPA17022A | Medicaid | CA | |
| 330311953 | Other | CA | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA17022 (California) | Primary |
| Entity Name | St Jude Emergency Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720190804 PECOS PAC ID: 8224923479 Enrollment ID: O20040217001064 |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon L Cornwell, PA 4401 W Memorial Rd, Suite 121, Oklahoma City, OK 73134-1785 Ph: (405) 751-4664 | Shannon L Cornwell, PA 101 E Valencia Mesa Dr, Em Dept, Fullerton, CA 92835-3809 Ph: (714) 992-3965 |
Rachel Jones, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2575 Yorba Linda Blvd, Fullerton, CA 92831 Phone: 714-449-7400 |
Austin James Perkins, PA-C, ATC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835 Phone: 714-626-8630 |
Hannah Hahn, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2575 Yorba Linda Blvd, Fullerton, CA 92831 Phone: 714-449-7400 |
Amy Wu, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2575 Yorba Linda Blvd, Fullerton, CA 92831 Phone: 213-550-7936 |
Nida Mansoor, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1565 S Harbor Blvd, Fullerton, CA 92832 Phone: 657-217-5755 |
Nina Ton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2575 Yorba Linda Blvd, Fullerton, CA 92831 Phone: 714-449-7400 |
Quint Skipton, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 301 W Bastanchury Rd, Suite 210, Fullerton, CA 92835 Phone: 714-879-9936 Fax: 714-879-3035 |