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NPI Code Detail

MEDICARE: SANDRA SHI

MEDICARE: SANDRA SHI
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
1207R00000XInternal Medicine Physician012063AZ

General Provider Information

NPI Number : 1588291298
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA SHI
Provider Business Mailing Address
First Line : 13640 N PLAZA DEL RIO BLVD
Second Line :
City : PEORIA
State : AZ
Zip : 85381-4846
Country : US
Telephone Number : 623-876-3800
Fax Number :
Provider Business Practice Location Address
First Line : 2000 W BETHANY HOME RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-2443
Country : US
Telephone Number : 623-561-7279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2020
Last Update Date : 12/01/2025

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Directions to “ SANDRA SHI ” Practice Location

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