Provider Demographics
NPI:1356071112
Name:SHAO, MINGYUE
Entity Type:Individual
Prefix:
First Name:MINGYUE
Middle Name:
Last Name:SHAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 W TEMPLE ST # MS
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-7329
Mailing Address - Country:US
Mailing Address - Phone:213-989-6100
Mailing Address - Fax:
Practice Address - Street 1:1711 W TEMPLE ST # MS
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-7329
Practice Address - Country:US
Practice Address - Phone:213-989-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95268163163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse