MEDICARE: YOGESH SHAH

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	183500000X	Pharmacist	50845	CA

General Provider Information

NPI Number	:	1750731097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOGESH SHAH

Provider Business Mailing Address
First Line	:	767 ADMIRAL CT
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-4755
Country	:	US
Telephone Number	:	818-707-9918
Fax Number	:

Provider Business Practice Location Address
First Line	:	767 ADMIRAL CT
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-4755
Country	:	US
Telephone Number	:	818-707-9918
Fax Number	:

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

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	06/17/2016

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Directions to “ YOGESH SHAH ” Practice Location

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