MEDICARE: KEVIN 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	207RC0000X	Cardiovascular Disease Physician	11330788-1205	UT
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	A127087	CA

General Provider Information

NPI Number	:	1861757544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN SHAH M.D.

Provider Business Mailing Address
First Line	:	3828 SCHAUFELE AVE STE 250
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808
Country	:	US
Telephone Number	:	657-241-8990
Fax Number	:

Provider Business Practice Location Address
First Line	:	3828 SCHAUFELE AVE STE 250
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808
Country	:	US
Telephone Number	:	657-241-8990
Fax Number	:

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

Provider Enumeration Date	:	07/10/2012
Last Update Date	:	04/28/2026

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Directions to “ KEVIN SHAH M.D.” Practice Location

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