Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A129443 | CA |
NPI | 1255531182 |
---|---|
Provider Name | Nirav Jayprakash Shah |
First Address | West Hills, CA 91307-1904 |
Second Address | West Hills, CA 91307-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 01/06/2021 |