Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A37099 | CA |
NPI | 1013000702 |
---|---|
Provider Name | Dr. Kamalatta U Shah |
First Address | Walnut, CA 91789-5306 |
Second Address | Walnut, CA 91789-5306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A370990 | (05) | CA |
A28296 | (02) | CA |