Individual provider · Type 1 NPI
Tyana Shaw
Clinical & Laboratory Immunology (Internal Medicine) Physician · Antioch, CA
NPI number
1669199642
Active
Practice location
4965 Ridgeview Dr
Antioch, CA 94531-7757
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical & Laboratory Immunology (Internal Medicine) Physician Primary | 207RI0001X | 207RI0001 (CA) |
Clinical & Laboratory Immunology (Internal Medicine) Physician: An internal medicine physician who specializes in clinical and laboratory immunology disease management.
About NPI 1669199642
Tyana Shaw's National Provider Identifier is 1669199642, issued on Oct 20, 2022. The primary taxonomy on file is Clinical & Laboratory Immunology (Internal Medicine) Physician (207RI0001X), and the practice location is in Antioch, CA. The record was last updated on Nov 12, 2022.