Provider Demographics
NPI:1902836992
Name:CHI, SHIRLEY Y (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:Y
Last Name:CHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:65 CROCUS ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4218
Mailing Address - Country:US
Mailing Address - Phone:312-520-8900
Mailing Address - Fax:714-777-7186
Practice Address - Street 1:301 W HUNTINGTON DR STE 419
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1507
Practice Address - Country:US
Practice Address - Phone:626-446-4663
Practice Address - Fax:714-777-7186
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA90282207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A902820Medicaid
CA00A902820Medicaid