Healthcare Provider Details

I. General information

NPI: 1710208210
Provider Name (Legal Business Name): SHINN-HUEY SHIRLEY CHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVENUE BLDG. 5, 1ST FL.
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

PO BOX 743749
LOS ANGELES CA
90074
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8020
  • Fax: 628-206-4004
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number262514
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116022669
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC194841
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD60393377
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: