Healthcare Provider Details

I. General information

NPI: 1003136870
Provider Name (Legal Business Name): ALLAN SHIAU RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S LONG BEACH BLVD
COMPTON CA
90221-3423
US

IV. Provider business mailing address

6119 N MUSCATEL AVE
SAN GABRIEL CA
91775-2624
US

V. Phone/Fax

Practice location:
  • Phone: 310-639-8026
  • Fax:
Mailing address:
  • Phone: 626-695-1413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: