Healthcare Provider Details

I. General information

NPI: 1265681134
Provider Name (Legal Business Name): AMEE SAURIN MAPARA-SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5132 FIOLI LOOP
SAN RAMON CA
94582-5976
US

IV. Provider business mailing address

5132 FIOLI LOOP
SAN RAMON CA
94582-5976
US

V. Phone/Fax

Practice location:
  • Phone: 518-312-7043
  • Fax:
Mailing address:
  • Phone: 518-312-7043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA112864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: