MEDICARE: DR. JIMMY SHIH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	13558	NV
2	2085R0202X	Diagnostic Radiology Physician	A108290	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346450087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIMMY SHIH M.D.

Provider Business Mailing Address
First Line	:	2020 PALOMINO LN
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4842
Country	:	US
Telephone Number	:	702-759-8600
Fax Number	:	702-384-1815

Provider Business Practice Location Address
First Line	:	2020 PALOMINO LN
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4842
Country	:	US
Telephone Number	:	702-759-8600
Fax Number	:	702-384-1815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	01/13/2023

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Directions to “ DR. JIMMY SHIH M.D.” Practice Location

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