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General NPI Number Information
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NPI Number | 1316178072
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Entity Type | Organization
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Legal Business Name | MAHIPAL M. SHAH, M.D.,P.C.
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 4950 SAN BERNARDINO ST SUITE 201
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City | MONTCLAIR
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State | CA
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Zip | 91763-2328
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Country | US
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Telephone | 909-626-1955
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Fax | 909-626-1141
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Provider Business Mailing Address
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Address Line | 4950 SAN BERNARDINO ST SUITE 201
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City | MONTCLAIR
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State | CA
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Zip | 91763-2328
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Country | US
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Telephone | 909-626-1955
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Fax | 909-626-1141
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHIPAL M SHAH
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Credential | M.D.
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Telephone | 909-626-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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