Provider Demographics
NPI:1760543920
Name:SHEN, HUA SHU (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:HUA SHU
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CARVER RD
Mailing Address - Street 2:P2
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4779
Mailing Address - Country:US
Mailing Address - Phone:209-527-6478
Mailing Address - Fax:209-527-6914
Practice Address - Street 1:1100 CARVER RD
Practice Address - Street 2:P2
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4779
Practice Address - Country:US
Practice Address - Phone:209-527-6478
Practice Address - Fax:209-527-6914
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4490171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist