Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A81146 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | A81146 | CA |
NPI | 1215016175 |
---|---|
Provider Name | Dr. Rong Shen |
First Address | San Francisco, CA 94133-4457 |
Second Address | San Francisco, CA 94133-4457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 09/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A811460 | (05) | CA |
00A811460 | 1 (01) | CA |
731678750 | 1 (01) | CA |
A81146 | 1 (01) | CA |
H81153 | (02) | CA |