Healthcare Provider Details

I. General information

NPI: 1720493943
Provider Name (Legal Business Name): SOHAM SHAH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 11/30/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 TRUXTUN AVE
BAKERSFIELD CA
93301-3602
US

IV. Provider business mailing address

10810 N TATUM BLVD STE 102-790
PHOENIX AZ
85028-6055
US

V. Phone/Fax

Practice location:
  • Phone: 661-328-8904
  • Fax: 714-340-2504
Mailing address:
  • Phone: 949-385-3460
  • Fax: 714-340-2504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS0087
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License NumberA151504
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR.0076477
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberS0087
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA151504
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number69084
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55638
License Number StateAZ
# 8
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA151504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: