MEDICARE: DR. SHIRLEY UY 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
1	207Q00000X	Family Medicine Physician	G55457	CA
2	207R00000X	Internal Medicine Physician	G55457	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G554570	OTHER	CA	MEDI-CAL PPIN #

General Provider Information

NPI Number	:	1881628824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIRLEY UY M.D.

Provider Business Mailing Address
First Line	:	200 UCLA MEDICAL PLZ
Second Line	:	SUITE 220
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1628
Country	:	US
Telephone Number	:	310-794-9956
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 UCLA MEDICAL PLZ
Second Line	:	SUITE 220
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1628
Country	:	US
Telephone Number	:	310-794-9956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/19/2007

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