Healthcare Provider Details

I. General information

NPI: 1881007813
Provider Name (Legal Business Name): NEEL SUNIL SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12291 WASHINGTON BLVD SUITE 500
WHITTIER CA
90606-2500
US

IV. Provider business mailing address

23523 WINDROSE PL
VALENCIA CA
91354-1505
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-2541
  • Fax:
Mailing address:
  • Phone: 661-363-3027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD70035271
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD227583
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-145387
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0076200
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: