MEDICARE: JANKI BHUVA SHAH MD

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
1	207RI0011X	Interventional Cardiology Physician	A79229	CA
2	207RC0000X	Cardiovascular Disease Physician	A79229	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497826325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANKI BHUVA SHAH MD

Provider Business Mailing Address
First Line	:	2020 SANTA MONICA BLVD
Second Line	:	SUITE 220
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2023
Country	:	US
Telephone Number	:	310-582-6220
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 SANTA MONICA BLVD
Second Line	:	SUITE 220
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2023
Country	:	US
Telephone Number	:	310-582-6220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	09/17/2012

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Directions to “ JANKI BHUVA SHAH MD” Practice Location

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