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NPI Code Detail

MEDICARE: DR. JING SHAN MD, PHD

MEDICARE: DR. JING SHAN MD, PHD
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
1207R00000XInternal Medicine Physician267374MA
2207W00000XOphthalmology PhysicianA150727CA

General Provider Information

NPI Number : 1982054896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JING SHAN MD, PHD
Provider Business Mailing Address
First Line : 490 ILLINOIS ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94158-2510
Country : US
Telephone Number : 415-514-6920
Fax Number : 415-514-6925
Provider Business Practice Location Address
First Line : 490 ILLINOIS ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94158-2510
Country : US
Telephone Number : 415-514-6920
Fax Number : 415-514-6925
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2016
Last Update Date : 10/20/2021

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