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General NPI Number Information
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NPI Number | 1689819039
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Entity Type | Organization
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Legal Business Name | SAMIR B. SHAH, MD, INC.
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 301 LENNON LN SUITE 201
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2483
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Country | US
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Telephone | 925-296-6100
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Fax | 925-932-8650
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Provider Business Mailing Address
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Address Line | 301 LENNON LN SUITE 201
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2483
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Country | US
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Telephone | 925-296-6100
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Fax | 925-932-8650
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMIR BIPIN SHAH
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Credential | MD
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Telephone | 925-296-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A68255
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License Number State | CA
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