Healthcare Provider Details

I. General information

NPI: 1871465476
Provider Name (Legal Business Name): DANG NAMBISAN & SHAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 ROSEMOUNT LN
SAN RAMON CA
94582-5696
US

IV. Provider business mailing address

2235 ROSEMOUNT LN
SAN RAMON CA
94582-5696
US

V. Phone/Fax

Practice location:
  • Phone: 925-858-3684
  • Fax: 209-834-5157
Mailing address:
  • Phone: 925-858-3684
  • Fax: 209-834-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAKHEE SHAH
Title or Position: OWNER
Credential: MD
Phone: 925-858-3684