Provider Demographics
NPI:1093137994
Name:SHIH, VIVIAN WEN-JIEH (OD)
Entity Type:Individual
Prefix:MISS
First Name:VIVIAN
Middle Name:WEN-JIEH
Last Name:SHIH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 E HUNTINGTON DR STE B
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3210
Mailing Address - Country:US
Mailing Address - Phone:626-303-1888
Mailing Address - Fax:
Practice Address - Street 1:29 E HUNTINGTON DR STE B
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3210
Practice Address - Country:US
Practice Address - Phone:626-303-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14831152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist