Provider Demographics
NPI:1851133920
Name:FU, CHIH-SHANG
Entity type:Individual
Prefix:
First Name:CHIH-SHANG
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MURPHY RANCH RD APT 242
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7995
Mailing Address - Country:US
Mailing Address - Phone:341-345-2474
Mailing Address - Fax:
Practice Address - Street 1:1061 A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4105
Practice Address - Country:US
Practice Address - Phone:510-459-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program