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General NPI Number Information
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NPI Number | 1538323647
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Entity Type | Organization
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Legal Business Name | JEN-KWAY SHEN, M.D., INC.
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 1850 S AZUSA AVE 118
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City | HACIENDA HTS
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State | CA
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Zip | 91745-6813
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Country | US
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Telephone | 626-854-2828
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Fax | 626-854-2829
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Provider Business Mailing Address
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Address Line | 1850 S AZUSA AVE 118
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City | HACIENDA HTS
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State | CA
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Zip | 91745-6813
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Country | US
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Telephone | 626-854-2828
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Fax | 626-854-2829
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEN-KWAY SHEN
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Credential | M.D.
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Telephone | 626-854-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A44321
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License Number State | CA
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