Provider Demographics
NPI:1407032162
Name:SHIUE, ZITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZITA
Middle Name:
Last Name:SHIUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 EAST ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2084
Mailing Address - Country:US
Mailing Address - Phone:925-686-1230
Mailing Address - Fax:
Practice Address - Street 1:2222 EAST ST
Practice Address - Street 2:SUITE 305
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2084
Practice Address - Country:US
Practice Address - Phone:215-605-0894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130320207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program