Provider Demographics
NPI:1003346354
Name:SHAH, JAY (DO, MBA)
Entity Type:Individual
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First Name:JAY
Middle Name:
Last Name:SHAH
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Gender:M
Credentials:DO, MBA
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Mailing Address - Street 1:400 PARNASSUS AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2202
Mailing Address - Country:US
Mailing Address - Phone:886-817-7463
Mailing Address - Fax:415-353-4047
Practice Address - Street 1:400 PARNASSUS AVE FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:886-817-7463
Practice Address - Fax:415-353-4047
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A19658207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery