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General NPI Number Information
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NPI Number | 1558448795
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Entity Type | Organization
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Legal Business Name | ADVANCED GI CONSULTANTS MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 4314 W VICTORY BLVD
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City | BURBANK
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State | CA
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Zip | 91505-1334
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Country | US
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Telephone | 818-845-1854
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Fax | 626-289-5686
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Provider Business Mailing Address
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Address Line | 4314 W VICTORY BLVD
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City | BURBANK
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State | CA
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Zip | 91505-1334
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Country | US
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Telephone | 818-845-1854
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Fax | 626-289-5686
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YEONG AN SHEU
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Credential | M.D.
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Telephone | 818-399-0556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A72217
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A72217
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License Number State | CA
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