Healthcare Provider Details

I. General information

NPI: 1851039796
Provider Name (Legal Business Name): KANDARP SHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

5820 OWENS DR BLDG E2ND
PLEASANTON CA
94588-3900
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-6032
  • Fax:
Mailing address:
  • Phone: 916-688-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA205008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: