Healthcare Provider Details

I. General information

NPI: 1417749599
Provider Name (Legal Business Name): TINA SHIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GROVE ST
SAN FRANCISCO CA
94102-4505
US

IV. Provider business mailing address

101 GROVE ST
SAN FRANCISCO CA
94102-4505
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: