Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A128805 | CA |
N | 111NI0900X | Internist | A128805 | CA |
N | 207RG0300X | Geriatric Medicine | A128805 | CA |
Y | 207RH0003X | Hematology & Oncology | A128805 | CA |
NPI | 1104183631 |
---|---|
Provider Name | John Shen |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2012 |
Last Update Date | 09/08/2018 |