Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A94938 | CA |
N | 207YS0123X | Facial Plastic Surgeon | A94938 | CA |
NPI | 1679761043 |
---|---|
Provider Name | Dr. Ted Shen |
First Address | Arcadia, CA 91006-3712 |
Second Address | Pasadena, CA 91106-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 10/03/2020 |