Provider Demographics
NPI:1730194168
Name:SHEW, STEPHEN BRIAN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BRIAN
Last Name:SHEW
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 1:710 LAWRENCE EXPY DEPT 286
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:408-851-2000
Mailing Address - Fax:408-851-2358
Practice Address - Street 1:710 LAWRENCE EXPY DEPT 286
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-2000
Practice Address - Fax:408-851-2358
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA864502086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A864500Medicaid
CAWA86450AMedicare PIN
CA00A864500Medicaid