Healthcare Provider Details

I. General information

NPI: 1093024929
Provider Name (Legal Business Name): ALAN SHIH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 12/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S ANAHEIM HILLS RD 234
ANAHEIM CA
92807-4780
US

IV. Provider business mailing address

500 S ANAHEIM HILLS RD 234
ANAHEIM CA
92807-4780
US

V. Phone/Fax

Practice location:
  • Phone: 714-282-5437
  • Fax: 714-282-8724
Mailing address:
  • Phone: 714-282-5437
  • Fax: 714-282-8724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA90053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: