Provider Demographics
NPI:1427223478
Name:KIRIT SHAH, M.D. INC.
Entity Type:Organization
Organization Name:KIRIT SHAH, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRIT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-445-5577
Mailing Address - Street 1:900 S 1ST AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7527
Mailing Address - Country:US
Mailing Address - Phone:626-445-5577
Mailing Address - Fax:626-445-2155
Practice Address - Street 1:900 S 1ST AVE STE A
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7527
Practice Address - Country:US
Practice Address - Phone:626-445-5577
Practice Address - Fax:626-445-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42536207R00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A425360Medicaid
CAC35539Medicare UPIN
CAA42536Medicare PIN