Healthcare Provider Details

I. General information

NPI: 1518281443
Provider Name (Legal Business Name): MEERA SRIDHAR SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEERA SRIDHAR

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 6D SFGH OB GYN
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

235 SHRADER ST APARTMENT #9
SAN FRANCISCO CA
94117-1854
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-3061
  • Fax:
Mailing address:
  • Phone: 510-612-4918
  • 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 State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA120118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: