Healthcare Provider Details

I. General information

NPI: 1972887438
Provider Name (Legal Business Name): CANDACE WAN-PING SHAVIT M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CANDACE WAN-PING CHENG M.D.

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE ROOM S436, BOX 0427
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

513 PARNASSUS AVE ROOM S436, BOX 0427
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 510-828-7238
  • Fax: 415-514-0185
Mailing address:
  • Phone: 510-828-7238
  • Fax: 415-514-0185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: