Healthcare Provider Details

I. General information

NPI: 1396944955
Provider Name (Legal Business Name): ANITA J SHEUNG MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 EL CAMINO REAL STE 201
BURLINGAME CA
94010-3111
US

IV. Provider business mailing address

1860 EL CAMINO REAL #201
BURLINGAME CA
94010
US

V. Phone/Fax

Practice location:
  • Phone: 650-259-8009
  • Fax:
Mailing address:
  • Phone: 650-259-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number29403
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: