# MICHAEL NIAN PENG SHI, L.AC., PH.D.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nian Peng Shi, L.Ac.,Ph.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336442078
- **Authorized official:** DR. NIAN PENG SHI MSTCM, PH.D. (OWNER)
- **Authorized official phone:** (510) 704-8888

## Contact information

- **Practice address:** 1919 ADDISON ST, SUITE 101, BERKELEY, CA 94704-1141
- **Practice address phone:** (510) 704-8888
- **Practice address fax:** (510) 704-1875
- **Mailing address:** 1919 ADDISON ST, SUITE 101, BERKELEY, CA 94704-1141
- **Mailing address phone:** (510) 704-8888
- **Mailing address fax:** (510) 704-1875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | AC4182 | CA | Yes |

## Other

- **Enumeration date:** 12/20/2010
- **Last updated:** 12/20/2010