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General NPI Number Information
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NPI Number | 1356908966
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Entity Type | Individual
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Provider Name | YESHA KAUSHIK SHAH DO
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 4501 SAND CREEK RD
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City | ANTIOCH
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State | CA
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Zip | 94531-8687
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Country | US
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Telephone | 415-429-9306
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Fax | 925-813-3876
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Provider Business Mailing Address
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Address Line | 4501 SAND CREEK RD
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City | ANTIOCH
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State | CA
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Zip | 94531-8687
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Country | US
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Telephone | 415-429-9306
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Fax | 925-813-3876
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OT019066
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A19983
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License Number State | CA
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