Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A32996 | CA |
NPI | 1003990151 |
---|---|
Provider Name | Dr. Roshan Ara Shah |
First Address | Oxnard, CA 93030-7647 |
Second Address | Oxnard, CA 93030-7647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |