Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301083428 | MI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | A107394 | CA |
NPI | 1174733802 |
---|---|
Provider Name | Dr. Shaunak Subhash Desai |
First Address | Newport Beach, CA 92660-7985 |
Second Address | Newport Beach, CA 92660-7985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DS084Y | (02) | CA |