Provider Demographics
NPI:1164563284
Name:SHENDEE TENG, M.D., INC
Entity Type:Organization
Organization Name:SHENDEE TENG, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHENDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:TENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-287-3213
Mailing Address - Street 1:1595 RUBIO DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2742
Mailing Address - Country:US
Mailing Address - Phone:626-287-3213
Mailing Address - Fax:626-287-3213
Practice Address - Street 1:15031 RINALDI ST
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1207
Practice Address - Country:US
Practice Address - Phone:818-898-4530
Practice Address - Fax:818-898-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG837982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09588Medicare UPIN