Provider Demographics
NPI:1952301061
Name:BRIAN SHIH MD INC
Entity Type:Organization
Organization Name:BRIAN SHIH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-301-6666
Mailing Address - Street 1:23975 PARK SORRENTO
Mailing Address - Street 2:SUITE 370
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-4015
Mailing Address - Country:US
Mailing Address - Phone:310-258-2400
Mailing Address - Fax:310-216-7154
Practice Address - Street 1:6840 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4401
Practice Address - Country:US
Practice Address - Phone:818-442-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62636207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18644AMedicare ID - Type UnspecifiedPROVIDER NUMBER
CAW18644Medicare ID - Type Unspecified