Shu Dong, N.P.
Nurse Practitioner in Banning, CA. Individual provider (NPI-1).
NPI number1376842005
StatusActive
Last updated in NPPESJul 10, 2024
Details
- NPI
- 1376842005
- Entity type
- Individual (NPI-1)
- Name
- Shu Dong
- Credential
- N.P.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2011
- Certification date
- Jul 10, 2024
- Last updated
- Jul 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 20192 | CA | Yes |
| 363LF0000X | Nurse Practitioner, Family | 1117425 | TX |
Practice location
12359 Malki RdBanning, CA 92220-6974
Phone 951-922-2058 · Fax 888-551-2116
Mailing address
12359 Malki RdBanning, CA 92220-6974
Phone 951-922-2058 · Fax 888-551-2116
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