Provider Demographics
NPI:1235214081
Name:DO, SHIANG L (DO)
Entity Type:Individual
Prefix:
First Name:SHIANG
Middle Name:L
Last Name:DO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-6756
Mailing Address - Country:US
Mailing Address - Phone:805-487-9897
Mailing Address - Fax:
Practice Address - Street 1:963 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-6756
Practice Address - Country:US
Practice Address - Phone:805-487-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10263208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235214081Medicaid
CA1831365667Medicaid
CA20A10263OtherCA MED LIC
CA1033357736Medicaid
CAZZZ55168YOtherBS/TRIWEST
CABG850Medicare PIN
CAW21724Medicare PIN
CA20A10263OtherCA MED LIC