Individual
DR. CHARLES SHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
136 GLASSON WAY, GRASS VALLEY, CA 95945-5706
(530) 272-8452
(530) 477-5182
Mailing address
280 SIERRA COLLEGE DR STE 205, GRASS VALLEY, CA 95945-5763
(530) 263-7321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L4709
TX
208M00000X
Hospitalist Physician
225106
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157966605
—
TX
01
—
157966606
MEDICAID CSHCN
TX
Enumeration date
01/11/2006
Last updated
06/16/2023
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