MEDICARE: DR. KIRITKUMAR S 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	A36850	CA

General Provider Information

NPI Number	:	1942246285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRITKUMAR S SHAH M.D.

Provider Business Mailing Address
First Line	:	1235 HIGHLAND OAKS DR
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-2429
Country	:	US
Telephone Number	:	323-697-0895
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1708
Country	:	US
Telephone Number	:	323-268-6751
Fax Number	:	323-269-4091

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/14/2018

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