Organization
ALFRED C SHEN MEDICAL CORPORATION
Active
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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