Provider Demographics
NPI:1417724931
Name:TWIN HEALTH MEDICAL GROUP CALIFORNIA PC
Entity Type:Organization
Organization Name:TWIN HEALTH MEDICAL GROUP CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MADHUKANTA
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-607-0776
Mailing Address - Street 1:2525 E CHARLESTON RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043
Mailing Address - Country:US
Mailing Address - Phone:408-675-3255
Mailing Address - Fax:
Practice Address - Street 1:2525 E CHARLESTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043
Practice Address - Country:US
Practice Address - Phone:408-675-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty