Healthcare Provider Details

I. General information

NPI: 1053948125
Provider Name (Legal Business Name): APEKSHA SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 220
COSTA MESA CA
92627-3786
US

IV. Provider business mailing address

11234 ANDERSON ST STE C
LOMA LINDA CA
92354-2804
US

V. Phone/Fax

Practice location:
  • Phone: 949-873-5352
  • Fax: 949-873-5394
Mailing address:
  • Phone: 909-558-4074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA185626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: