Provider Demographics
NPI:1518386663
Name:SHAH, SHAILY DINESH (MD)
Entity Type:Individual
Prefix:
First Name:SHAILY
Middle Name:DINESH
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 LENNON LN STE 210
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5912
Mailing Address - Country:US
Mailing Address - Phone:925-947-0888
Mailing Address - Fax:925-947-4385
Practice Address - Street 1:365 LENNON LN STE 210
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-5912
Practice Address - Country:US
Practice Address - Phone:925-947-0888
Practice Address - Fax:925-947-4385
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293667207W00000X
CAA170934207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology