Provider Demographics
NPI:1710052741
Name:SHEN, JEN YEE (MD)
Entity Type:Individual
Prefix:
First Name:JEN YEE
Middle Name:
Last Name:SHEN
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 1:801 W VALLEY BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3256
Mailing Address - Country:US
Mailing Address - Phone:626-282-6929
Mailing Address - Fax:626-282-4549
Practice Address - Street 1:801 W VALLEY BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-3256
Practice Address - Country:US
Practice Address - Phone:626-282-6929
Practice Address - Fax:626-282-4549
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42233174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist