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General NPI Number Information
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NPI Number | 1265755086
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Entity Type | Organization
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Legal Business Name | UMESH C SHAH MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 12540 10TH ST STE B
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City | CHINO
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State | CA
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Zip | 91710-3503
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Country | US
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Telephone | 909-591-6414
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Fax | 909-628-1405
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Provider Business Mailing Address
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Address Line | 12540 10TH ST STE B
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City | CHINO
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State | CA
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Zip | 91710-3503
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Country | US
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Telephone | 909-591-6414
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Fax | 909-628-1405
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. UMESH SHAH
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Credential | MD
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Telephone | 909-591-6414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A34147
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License Number State | CA
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