Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A101846 | CA |
N | 208000000X | Pediatrician | A101846 | CA |
NPI | 1477633816 |
---|---|
Provider Name | Joseph Jusing Shen |
First Address | Sacramento, CA 95831-1074 |
Second Address | Sacramento, CA 95817-2310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I48700 | (02) |