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General NPI Number Information
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NPI Number | 1104610518
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Entity Type | Organization
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Legal Business Name | ROSHNI SHAH PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 18574 PROSPECT RD
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City | SARATOGA
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State | CA
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Zip | 95070-3646
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Country | US
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Telephone | 925-917-9762
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Fax |
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Provider Business Mailing Address
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Address Line | 2191 WELLINGTON DR
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City | MILPITAS
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State | CA
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Zip | 95035-7513
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Country | US
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Telephone | 925-917-9762
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | ROSHNI SHAH
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Credential | OD
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Telephone | 925-917-9762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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