Provider Demographics
NPI:1609837772
Name:SHEN, LILLIAN SHIN-YUEN (OD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:SHIN-YUEN
Last Name:SHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 BELLFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5636
Mailing Address - Country:US
Mailing Address - Phone:925-648-7826
Mailing Address - Fax:
Practice Address - Street 1:540 DAVIS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-1902
Practice Address - Country:US
Practice Address - Phone:415-956-1850
Practice Address - Fax:415-391-3852
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11210T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU76340Medicare UPIN