Provider Demographics
NPI:1013935154
Name:SHIH, CHIN SHUN (MD)
Entity Type:Individual
Prefix:
First Name:CHIN SHUN
Middle Name:
Last Name:SHIH
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 1:223 N GARFIELD AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1700
Mailing Address - Country:US
Mailing Address - Phone:626-573-1941
Mailing Address - Fax:626-573-5624
Practice Address - Street 1:223 N GARFIELD AVE STE 305
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1700
Practice Address - Country:US
Practice Address - Phone:626-573-1941
Practice Address - Fax:626-573-5624
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34731207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34731Medicaid
CAA34731Medicaid
CAA34731Medicare PIN