Yan, Jie Shi

Yan, Jie Shi is an individual health care provider with primary practice located at 2925 Sycamore Dr Suite 160, Simi Valley CA 93065-1207. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Yan, Jie Shi can be contacted via phone (805) 584-0177.

Contact Information

Primary practice address
2925 Sycamore Dr Suite 160 Simi Valley CA 93065-1207
Fax: (805) 584-1179
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A78071 California

Profile Details

NPI number 1396744546
LBN Legal business name Yan, Jie Shi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jul 18th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396744546 NPPES
California Other A78071 CALIFORNIA LICENSE NUMBER
California MEDICAID 00A780710 CALIFORNIA LICENSE NUMBER

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