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Individual

GARY G SHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
617 NEW YORK RANCH RD, JACKSON, CA 95642-9328
(209) 257-0292
(209) 257-0676
Mailing address
617 NEW YORK RANCH RD, JACKSON, CA 95642-9328
(209) 257-0292
(209) 257-0676

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A92230
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A92230
MEDICAL LICENSE
CA
Enumeration date
02/02/2006
Last updated
01/23/2012
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