Provider Demographics
NPI:1114102969
Name:KANDARP K. SHAH, M.D., INC
Entity Type:Organization
Organization Name:KANDARP K. SHAH, M.D., INC
Other - Org Name:VALLEY GASTROENTEROLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDARP
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-625-9100
Mailing Address - Street 1:6569 N RIVERSIDE DR # 102504
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-9318
Mailing Address - Country:US
Mailing Address - Phone:559-625-9100
Mailing Address - Fax:559-625-9103
Practice Address - Street 1:518 N COURT ST STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4920
Practice Address - Country:US
Practice Address - Phone:559-625-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB09292Medicare UPIN