Provider Demographics
NPI:1821296344
Name:SHEN, MINHUA (LAC)
Entity Type:Individual
Prefix:
First Name:MINHUA
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 CAMINO DOS RIOS
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1137
Mailing Address - Country:US
Mailing Address - Phone:805-498-8585
Mailing Address - Fax:805-498-0400
Practice Address - Street 1:2824 CAMINO DOS RIOS
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-1137
Practice Address - Country:US
Practice Address - Phone:805-498-8585
Practice Address - Fax:805-498-0400
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11574171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist