Healthcare Provider Details

I. General information

NPI: 1356404875
Provider Name (Legal Business Name): ADVANCED GI CONSULTANTS MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 S GARFIELD AVE # 203
ALHAMBRA CA
91801-4713
US

IV. Provider business mailing address

1118 S GARFIELD AVE # 203
ALHAMBRA CA
91801-4713
US

V. Phone/Fax

Practice location:
  • Phone: 626-289-5688
  • Fax: 626-289-5686
Mailing address:
  • Phone: 626-289-5688
  • Fax: 626-289-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA72217
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA72217
License Number StateCA

VIII. Authorized Official

Name: YEONG AN SHEU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-289-5688