Healthcare Provider Details

I. General information

NPI: 1508215716
Provider Name (Legal Business Name): SHIVANI VORA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 12/03/2022
Certification Date: 12/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 FOREST AVE
SAN JOSE CA
95128-1425
US

IV. Provider business mailing address

2105 FOREST AVE
SAN JOSE CA
95128-1425
US

V. Phone/Fax

Practice location:
  • Phone: 408-947-5200
  • Fax:
Mailing address:
  • Phone: 408-947-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA158699
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA158699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: