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General NPI Number Information
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NPI Number | 1306991625
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Entity Type | Organization
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Legal Business Name | JOHN T SHEN MD, CORP
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 27403 YNEZ RD SUITE 106
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City | TEMECULA
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State | CA
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Zip | 92591-5603
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Country | US
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Telephone | 951-526-2044
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Fax | 951-332-9008
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Provider Business Mailing Address
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Address Line | 27403 YNEZ RD SUITE 106
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City | TEMECULA
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State | CA
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Zip | 92591-5603
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Country | US
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Telephone | 951-526-2044
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Fax | 951-332-9008
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KAREN NELSON SHEN
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Credential |
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Telephone | 951-302-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A86100
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License Number State | CA
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