Basic Information
Provider Information
NPI: 1134375272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHIU
FirstName: PERKIN
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT 34929
Address2: P.O. BOX 39000
City: SAN FRANCISCO
State: CA
PostalCode: 941390001
CountryCode: US
TelephoneNumber: 9259522828
FaxNumber: 9259522850
Practice Location
Address1: 1450 TREAT BLVD
Address2: SUITE 220B
City: WALNUT CREEK
State: CA
PostalCode: 945972168
CountryCode: US
TelephoneNumber: 9259371770
FaxNumber: 9259370630
Other Information
ProviderEnumerationDate: 08/08/2008
LastUpdateDate: 08/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XA89923CAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
P0147456801CARAILROAD MEDICAREOTHER


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