Organization
JOHN T SHEN MD, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN NELSON SHEN (ADMINISTRATOR)
(951) 302-0959
Entity
Organization
Contact information
Practice address
27403 YNEZ RD, SUITE 106, TEMECULA, CA 92591-5603
(951) 526-2044
(951) 332-9008
Mailing address
27403 YNEZ RD, SUITE 106, TEMECULA, CA 92591-5603
(951) 526-2044
(951) 332-9008
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A86100
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A861000
BLUESHIELD
CA
01
—
DF8874
RAILROAD MEDICARE GROUP
CA
01
—
P00399725
RAILROAD MEDICARE PTAN
CA
Enumeration date
01/25/2007
Last updated
03/25/2008
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