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General NPI Number Information
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NPI Number | 1003111642
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Entity Type | Individual
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Provider Name | SHENDEE TENG M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 1595 RUBIO DR
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City | SAN MARINO
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State | CA
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Zip | 91108-2742
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Country | US
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Telephone | 626-287-3213
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Fax |
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Provider Business Mailing Address
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Address Line | 1595 RUBIO DR
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City | SAN MARINO
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State | CA
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Zip | 91108-2742
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Country | US
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Telephone | 626-287-3213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G83798
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License Number State | CA
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