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General NPI Number Information
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NPI Number | 1942246285
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Entity Type | Individual
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Provider Name | KIRITKUMAR S SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 12/14/2018
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Provider Practice Location Address
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Address Line | 3434 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-1708
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Country | US
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Telephone | 323-268-6751
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Fax | 323-269-4091
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Provider Business Mailing Address
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Address Line | 1235 HIGHLAND OAKS DR
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City | ARCADIA
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State | CA
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Zip | 91006-2429
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Country | US
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Telephone | 323-697-0895
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A36850
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License Number State | CA
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