Healthcare Provider Details

I. General information

NPI: 1235096124
Provider Name (Legal Business Name): VALLEY GASTRO SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 E ALMOND AVE SUITE 103
MADERA CA
93637-5562
US

IV. Provider business mailing address

6569 N RIVERSIDE DR, #102504
FRESNO CA
93722-9318
US

V. Phone/Fax

Practice location:
  • Phone: 559-550-3511
  • Fax: 559-795-3368
Mailing address:
  • Phone: 559-550-3511
  • Fax: 559-795-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: KANDARP SHAH
Title or Position: OWNER
Credential:
Phone: 559-367-8432