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General NPI Number Information
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NPI Number | 1336263011
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Entity Type | Organization
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Legal Business Name | HARSHAD SHAH MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 1533 ALAMITOS AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-2214
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Country | US
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Telephone | 310-867-3493
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Fax | 714-236-4199
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Provider Business Mailing Address
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Address Line | 9648 SEVILLE WAY
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City | CYPRESS
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State | CA
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Zip | 90630-6804
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Country | US
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Telephone | 310-867-3493
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Fax | 714-236-4199
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARSHAD SHAH
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Credential | M.D
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Telephone | 310-867-3493
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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 | A53132
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License Number State | CA
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