Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | G57032 | CA |
NPI | 1124166095 |
---|---|
Provider Name | Dr. Frederick T Shum |
First Address | Whittier, CA 90608-0720 |
Second Address | Whittier, CA 90602-1006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1447398300 | NPI GROUP # (01) | CA |