Individual
JEN-KWAY SHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 S AZUSA AVE, HACIENDA HTS, CA 91745-6813
(626) 854-2828
(626) 854-2829
Mailing address
1629 SIALIC PL, LA HABRA HEIGHTS, CA 90631-8088
(626) 854-2828
(626) 854-2829
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A44321
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A443210
—
CA
01
—
A44321
PRIVATE INSURANCE
CA
Enumeration date
04/04/2006
Last updated
12/28/2016
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