Basic Information
| Provider Information | |||||||||
| NPI: | 1164431615 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEN | ||||||||
| FirstName: | SHIRLEY | ||||||||
| MiddleName: | YI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3637 MISSION AVE | ||||||||
| Address2: | BLDG A SUITE 5 | ||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956082946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168631496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 B GALE WILSON BLVD | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945333552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074297844 | ||||||||
| FaxNumber: | 7076939392 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | A81915 | CA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.