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General NPI Number Information
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NPI Number | 1528659984
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Entity Type | Individual
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Provider Name | SHEENA AMIN SHAH PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 502 EUCLID AVE STE 204
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2949
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Country | US
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Telephone | 619-331-3992
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Fax |
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Provider Business Mailing Address
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Address Line | 9025 SYDNEY CT UNIT 12302
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City | SAN DIEGO
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State | CA
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Zip | 92122-1624
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Country | US
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Telephone | 909-456-6969
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA59071
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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