Provider Demographics
NPI:1700865177
Name:SHEU, YEONG AN (MD)
Entity Type:Individual
Prefix:DR
First Name:YEONG AN
Middle Name:
Last Name:SHEU
Suffix:
Gender:M
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:PO BOX 80940
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91118-8940
Mailing Address - Country:US
Mailing Address - Phone:626-289-5688
Mailing Address - Fax:626-289-5686
Practice Address - Street 1:4314 W VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1334
Practice Address - Country:US
Practice Address - Phone:818-845-1854
Practice Address - Fax:626-289-5686
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72217207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A722170Medicaid
H17059Medicare UPIN
WA72217BMedicare ID - Type Unspecified