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NPI Code Detail

MEDICARE: RAJ K. SHAH M.D.

MEDICARE: RAJ K. SHAH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician83627CT
22085R0202XDiagnostic Radiology PhysicianA155313CA
3390200000XStudent in an Organized Health Care Education/Training Program
42085R0204XVascular & Interventional Radiology PhysicianA155313CA

General Provider Information

NPI Number : 1174882583
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJ K. SHAH M.D.
Provider Business Mailing Address
First Line : PO BOX 411185
Second Line :
City : BOSTON
State : MA
Zip : 02241-1185
Country : US
Telephone Number : 610-644-8900
Fax Number : 484-924-0053
Provider Business Practice Location Address
First Line : 16506 LAKEWOOD BLVD STE 200
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-5165
Country : US
Telephone Number : 562-888-8961
Fax Number : 562-888-8962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2012
Last Update Date : 01/22/2026

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