Provider Demographics
NPI:1124373626
Name:SHIH, HUNG WEN
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:WEN
Last Name:SHIH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HUNGWEN
Other - Middle Name:
Other - Last Name:SHIH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:41067 PEMENTEL CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3907
Mailing Address - Country:US
Mailing Address - Phone:408-646-0860
Mailing Address - Fax:
Practice Address - Street 1:41067 PEMENTEL COURT
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3907
Practice Address - Country:US
Practice Address - Phone:408-646-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14932171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist