Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A173272 | CA |
NPI | 1003203738 |
---|---|
Provider Name | Anup Shah |
First Address | Glendale, CA 91206-4140 |
Second Address | Glendale, CA 91206-4140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 29/10/2021 |