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General NPI Number Information
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NPI Number | 1194211342
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Entity Type | Organization
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Legal Business Name | J SHAH ORTHOPAEDICS INC
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 11/05/2018
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Provider Practice Location Address
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Address Line | 2615 PACIFIC COAST HWY STE 326
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2227
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Country | US
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Telephone | 630-947-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 2615 PACIFIC COAST HWY STE 326
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2227
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Country | US
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Telephone | 630-947-3233
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Fax |
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Authorized Official
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Title or Position | OWNER AND PHYSICIAN
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Name | DR. JALAAL SHAH
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Credential | DO
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Telephone | 630-947-3233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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