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NPI Code Detail

MEDICARE: ANITA G SHAH N.P.

MEDICARE: ANITA G SHAH N.P.
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
1363LF0000XFamily Nurse PractitionerAPN.0993293-NPCO
2363LF0000XFamily Nurse Practitioner95037688CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112291622OTHERCAQH

General Provider Information

NPI Number : 1932488467
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA G SHAH N.P.
Provider Business Mailing Address
First Line : PO BOX 511250
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-7805
Country : US
Telephone Number : 510-929-1400
Fax Number : 510-929-1414
Provider Business Practice Location Address
First Line : 1901 4TH ST STE 201
Second Line :
City : BERKELEY
State : CA
Zip : 94710-1986
Country : US
Telephone Number : 510-929-1400
Fax Number : 510-929-1414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2011
Last Update Date : 03/06/2026

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