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General NPI Number Information
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NPI Number | 1265484869
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Entity Type | Individual
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Provider Name | DEVAL AJIT SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 3930 24TH ST APT # 11
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3741
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Country | US
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Telephone | 650-714-9820
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Fax | 415-826-9324
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Provider Business Mailing Address
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Address Line | 12625 HIGH BLUFF DR STE 202
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City | SAN DIEGO
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State | CA
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Zip | 92130-2053
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Country | US
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Telephone | 650-733-4345
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Fax | 253-455-7891
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A91948
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License Number State | CA
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