Healthcare Provider Details

I. General information

NPI: 1518943794
Provider Name (Legal Business Name): STEVE CHIA-HUA SHIUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9268 PALOMINO RIDGE DR
LAKESIDE CA
92040-5812
US

IV. Provider business mailing address

PO BOX 34120
RENO NV
89533-4120
US

V. Phone/Fax

Practice location:
  • Phone: 775-747-5050
  • Fax: 775-747-5050
Mailing address:
  • Phone: 775-747-5050
  • Fax: 775-747-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH39621
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG85982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: