Provider Demographics
NPI:1225020886
Name:SHAH, PARAG ARVIND (MD)
Entity Type:Individual
Prefix:
First Name:PARAG
Middle Name:ARVIND
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11550 INDIAN HILLS RD
Mailing Address - Street 2:SUITE 371
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1200
Mailing Address - Country:US
Mailing Address - Phone:818-365-1194
Mailing Address - Fax:818-898-3835
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:SUITE 371
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:818-365-1194
Practice Address - Fax:818-898-3835
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2012-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA78966207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A789660Medicaid
CAH62586Medicare UPIN
CA00A789660Medicaid