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Organization

ALFRED C SHEN MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALFRED C SHEN M.D. (PRESIDENT)
(760) 895-0639
Entity
Organization

Contact information

Practice address
72780 COUNTRY CLUB DR STE A104, RANCHO MIRAGE, CA 92270-4150
(760) 895-0639
(760) 423-6339
Mailing address
PO BOX 217, RANCHO MIRAGE, CA 92270-0217
(760) 895-0639
(760) 423-6339

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A52041
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A520411
MEDICARE
CA
01
A52041
CA MEDICAL LICENSE
CA
Enumeration date
11/01/2006
Last updated
06/28/2024
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