Provider Demographics
NPI:1730329996
Name:SHI, JIANMIN (MS)
Entity type:Individual
Prefix:MR
First Name:JIANMIN
Middle Name:
Last Name:SHI
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2325
Mailing Address - Country:US
Mailing Address - Phone:626-578-9999
Mailing Address - Fax:
Practice Address - Street 1:965 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2325
Practice Address - Country:US
Practice Address - Phone:626-288-4312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-01
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12829171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist