Provider Demographics
NPI:1356382568
Name:SHIN, MAUNG TUN (MD)
Entity type:Individual
Prefix:MR
First Name:MAUNG
Middle Name:TUN
Last Name:SHIN
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 1:170 ALAMEDA BLUVD
Mailing Address - Street 2:SEQUOIA HEALTH CENTER
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062
Mailing Address - Country:US
Mailing Address - Phone:650-903-9500
Mailing Address - Fax:
Practice Address - Street 1:170 ALMEDA BLUVD
Practice Address - Street 2:SEQUOIA HEALTH CENTER
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-367-5632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30387207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A303870Medicaid
CA00A303870Medicare ID - Type Unspecified
CA00A303870Medicaid