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Dr. Shannon Mentock, MD
Family Medicine Physician in Petaluma, California
NPI 1104353796

Shannon Mentock is a Family Medicine Physician based in Petaluma, CA. Shannon Mentock practices in Petaluma, CA and has the professional credentials of MD. The NPI Number for Shannon Mentock is 1104353796 and holds a License No. (California).

The current practice location address for Shannon Mentock is 1179 N Mcdowell Blvd, Petaluma, CA and can be reached out via phone at 707-559-7500 and via fax at 707-559-7620.

Location: 1179 N Mcdowell Blvd, Petaluma, CA, 94954-6559
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104353796
Provider Name
Shannon Mentock
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1179 N Mcdowell Blvd, Petaluma, CA, 94954-6559
Phone Number
707-559-7500
Fax Number
707-559-7620
Provider Enumeration Date
05/15/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1179 N Mcdowell Blvd
City
Petaluma
State
California
Zip
94954-6559
Phone Number
707-559-7500
Fax Number
707-559-7620
person
Provider Business Mailing Address Details
Address
1179 N Mcdowell Blvd
City
Petaluma
State
California
Zip
94954-6559
Phone Number
707-559-7500
Fax Number
707-559-7620
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
DR.0063003 (Colorado)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Colorado)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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