Provider Demographics
NPI:1053345009
Name:SHEAR, STUART L (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:L
Last Name:SHEAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1706
Mailing Address - Country:US
Mailing Address - Phone:818-955-8877
Mailing Address - Fax:818-955-8845
Practice Address - Street 1:2121 W MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1706
Practice Address - Country:US
Practice Address - Phone:818-955-8877
Practice Address - Fax:818-955-8845
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37056207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G370560Medicaid
CAG37056Medicare ID - Type Unspecified