Healthcare Provider Details

I. General information

NPI: 1366600330
Provider Name (Legal Business Name): WHITNEY WANNI SHIAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 EASTMOOR AVE
DALY CITY CA
94015-2036
US

IV. Provider business mailing address

211 EASTMOOR AVE
DALY CITY CA
94015-2036
US

V. Phone/Fax

Practice location:
  • Phone: 650-550-3923
  • Fax: 650-756-3472
Mailing address:
  • Phone: 650-550-3923
  • Fax: 650-756-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA112289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: