Healthcare Provider Details

I. General information

NPI: 1417724931
Provider Name (Legal Business Name): TWIN HEALTH MEDICAL GROUP CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 BOHANNON DRIVE SUITE 280
MENLO PARK CA
94025
US

IV. Provider business mailing address

2525 E CHARLESTON RD SUITE 104
MOUNTAIN VIEW CA
94043
US

V. Phone/Fax

Practice location:
  • Phone: 408-675-3255
  • Fax:
Mailing address:
  • Phone: 408-675-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA MADHUKANTA SHAH
Title or Position: EVP & CHIEF MEDICAL OFFICER
Credential: M.D.
Phone: 312-607-0776