Individual
DR. LEO MENG-TAH SHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
959 E WALNUT ST, SUITE 120, PASADENA, CA 91106-1451
(626) 795-1831
(626) 795-2716
Mailing address
959 E WALNUT ST, SUITE 120, PASADENA, CA 91106-1451
(626) 795-1831
(626) 795-2716
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MT188668
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A121518
CA
207RP1001X
Pulmonary Disease Physician
A121518
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W481
MEDICARE GROUP NUMBER
—
Enumeration date
09/08/2007
Last updated
09/07/2017
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