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General NPI Number Information
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NPI Number | 1356427603
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Entity Type | Organization
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Legal Business Name | NAYANA SHAH M.D. INC.
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Dates
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Enumeration Date | 10/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16152 BEACH BLVD #200
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3806
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Country | US
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Telephone | 714-841-6772
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Fax | 714-841-6775
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Provider Business Mailing Address
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Address Line | 24551 RAYMOND WAY #200
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City | LAKE FOREST
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State | CA
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Zip | 92630-4400
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Country | US
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Telephone | 949-583-0925
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Fax | 949-583-7973
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NAYANA SHAH
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Credential | M.D.
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Telephone | 949-583-0925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A37530
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License Number State | CA
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