Provider Demographics
NPI:1659314821
Name:SHIH, ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SHIH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2306
Mailing Address - Country:US
Mailing Address - Phone:520-545-0202
Mailing Address - Fax:520-545-0201
Practice Address - Street 1:7406 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2306
Practice Address - Country:US
Practice Address - Phone:520-545-0202
Practice Address - Fax:520-545-0201
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0577213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ110325OtherMEDICARE GROUP PIN
AZV09814Medicare UPIN
AZ110326Medicare PIN