Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 50971 | MN |
N | 111NI0900X | Internist | 50971 | MN |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 35122056 | OH |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | C159832 | CA |
NPI | 1104026558 |
---|---|
Provider Name | I-Tsyr Shaw |
First Address | Sacramento, CA 95814-1929 |
Second Address | Sacramento, CA 95821-4807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 06/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0090475 | (05) | OH |