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NPI Code Detail

MEDICARE: DR. KERRY SHEU M.D.

MEDICARE: DR. KERRY SHEU M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianG58220CA
2208000000XPediatrics Physician58220CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1370020281OTHERCARAILROAD MEDICARE
4370020281OTHERCAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
300G582200OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1174636310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERRY SHEU M.D.
Provider Business Mailing Address
First Line : 75 REMITTANCE DR DEPT 6008
Second Line :
City : CHICAGO
State : IL
Zip : 60675-6008
Country : US
Telephone Number : 562-282-1419
Fax Number : 562-920-4642
Provider Business Practice Location Address
First Line : 4476 TWEEDY BLVD
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-6359
Country : US
Telephone Number : 323-563-9499
Fax Number : 323-563-0956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 07/15/2016

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Directions to “ DR. KERRY SHEU M.D.” Practice Location

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