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Individual
SHUNG L NIP
Active
Individual
SHUNG L NIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
4930
AZ
363AM0700X
Medical Physician Assistant
Primary
PA186105
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767347
—
AZ
01
—
Z157989
MEDICARE PTAN
—
Enumeration date
09/20/2011
Last updated
05/25/2023
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