MEDICARE: HIREN C 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
1	207Q00000X	Family Medicine Physician	A42703	CA
2	207RN0300X	Nephrology Physician	A42703	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	:	1578664934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIREN C SHAH M.D.

Provider Business Mailing Address
First Line	:	19713 YORBA LINDA BLVD
Second Line	:	SUITE#54
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3532
Country	:	US
Telephone Number	:	626-810-3330
Fax Number	:	626-964-0440

Provider Business Practice Location Address
First Line	:	19713 YORBA LINDA BLVD
Second Line	:	SUITE#54
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-3532
Country	:	US
Telephone Number	:	626-810-3330
Fax Number	:	626-964-0440

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/19/2012

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Directions to “ HIREN C SHAH M.D.” Practice Location

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