Healthcare Provider Details

I. General information

NPI: 1720346570
Provider Name (Legal Business Name): PRACHI SHUKLA DIXIT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRACHI SHUKLA

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E CALAVERAS BLVD FL 2
MILPITAS CA
95035-5491
US

IV. Provider business mailing address

770 E CALAVERAS BLVD FL 2
MILPITAS CA
95035-5491
US

V. Phone/Fax

Practice location:
  • Phone: 408-945-2933
  • Fax:
Mailing address:
  • Phone: 408-945-2933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA128297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: