Basic Information
| Provider Information | |||||||||
| NPI: | 1770585515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHIENER | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4849 VAN NUYS BLVD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SHERMAN OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914032110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185015686 | ||||||||
| FaxNumber: | 8185015688 | ||||||||
| Practice Location | |||||||||
| Address1: | 4849 VAN NUYS BLVD | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SHERMAN OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914032110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185015686 | ||||||||
| FaxNumber: | 8185018509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 02/25/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | G30423 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 00G304230 | 05 | CA | MEDICAID | ZZZ94648Z | 01 | CA | BLUE SHIELD | OTHER | 060047086 | 01 | CA | RAILROAD MEDICARE | OTHER | 95354702891403B003 | 01 | CA | TRICARE WEST REGION | OTHER |