Individual
DR. FRED SHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8599 HAVEN AVE., SUITE 300, RANCHO CUCAMONGA, CA 91730-4849
(909) 620-8180
(909) 919-7288
Mailing address
1121 SITUS CT, STE 170, RALEIGH, NC 27606-4279
(919) 834-2767
(919) 834-0234
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2006-01622
NC
2085R0202X
Diagnostic Radiology Physician
25060
NH
2085R0202X
Diagnostic Radiology Physician
Primary
A70061
CA
2085R0202X
Diagnostic Radiology Physician
MD27699
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A700610
—
CA
05
—
1568435717
—
ME
01
—
CG1263
RAILROAD MEDICARE
CA
Enumeration date
02/08/2006
Last updated
12/19/2023
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