Provider Demographics
NPI:1336324979
Name:SHIH, GARY W (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:W
Last Name:SHIH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:HOUSE STAFF OFFICE CP 21005
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:HOUSE STAFF OFFICE CP 21005
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4475
Practice Address - Fax:909-558-0216
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2015-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA107161207LC0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program