Provider Demographics
NPI:1679761043
Name:SHEN, TED (MD)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N 5TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3712
Mailing Address - Country:US
Mailing Address - Phone:626-737-6200
Mailing Address - Fax:626-737-6202
Practice Address - Street 1:225 S 1ST AVE STE 201
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3662
Practice Address - Country:US
Practice Address - Phone:626-737-6200
Practice Address - Fax:626-737-6202
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94938207YS0123X, 207YX0602X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy