=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508495433
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL SHIU
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2020
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 S SAN MATEO DR STE 307
-----------------------------------------------------
City | SAN MATEO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94401-3844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-348-6011
-----------------------------------------------------
Fax | 650-348-6027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 S SAN MATEO DR STE 307
-----------------------------------------------------
City | SAN MATEO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94401-3844
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-348-6011
-----------------------------------------------------
Fax | 650-348-6027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | 21306
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------