Provider Demographics
NPI:1063483162
Name:SHIH, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:SHIH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12626 RIVERSIDE DR
Mailing Address - Street 2:STE 302
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3474
Mailing Address - Country:US
Mailing Address - Phone:818-986-0200
Mailing Address - Fax:818-986-4393
Practice Address - Street 1:17525 VENTURA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5109
Practice Address - Country:US
Practice Address - Phone:818-986-0200
Practice Address - Fax:818-986-4393
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62636207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH10462Medicare UPIN