Provider Demographics
NPI:1295216570
Name:SHIH, YUN
Entity type:Individual
Prefix:
First Name:YUN
Middle Name:
Last Name:SHIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 TERRACE LN W UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1317 W FOOTHILL BLVD STE 148
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3675
Practice Address - Country:US
Practice Address - Phone:909-981-5882
Practice Address - Fax:909-373-2828
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1071211246ZN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrologyGroup - Single Specialty