Healthcare Provider Details

I. General information

NPI: 1811084197
Provider Name (Legal Business Name): HITESH ZAVERCHAND SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9802 STOCKDALE HWY STE 103
BAKERSFIELD CA
93311-3653
US

IV. Provider business mailing address

9802 STOCKDALE HWY STE 103
BAKERSFIELD CA
93311-3653
US

V. Phone/Fax

Practice location:
  • Phone: 661-663-4444
  • Fax: 661-663-4100
Mailing address:
  • Phone: 661-663-4444
  • Fax: 661-663-4100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA43422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: