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1780680546

NPI Code Detail

MEDICARE: DR. YATIN SHAH M.D.

MEDICARE: DR. YATIN SHAH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	C53259	CA
2	208000000X	Pediatrics Physician	K1668	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83Y185	OTHER	TX	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1655359001	OTHER	TX	CIGNA PROV NUMBER
4	123734100	OTHER	TX	FIRST CARE PROV NUMBER
5	141962301	OTHER	TX	UNITED HEALTHCARE PROV NO
6	5004343	OTHER	TX	AETNA PROVIDER NUMBER

General Provider Information

NPI Number	:	1780680546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YATIN SHAH M.D.

Provider Business Mailing Address
First Line	:	325 DISTEL CIR
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1408
Country	:	US
Telephone Number	:	925-875-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 DUBLIN BLVD
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-3112
Country	:	US
Telephone Number	:	925-875-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	05/29/2020

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Directions to “ DR. YATIN SHAH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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