Healthcare Provider Details

I. General information

NPI: 1750540647
Provider Name (Legal Business Name): ALBERT SHIEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E CALIFORNIA BLVD SUITE 204
PASADENA CA
91105-3954
US

IV. Provider business mailing address

55 E CALIFORNIA BLVD SUITE 204
PASADENA CA
91105-3954
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-8323
  • Fax:
Mailing address:
  • Phone: 626-397-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA118433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: