Provider Demographics
NPI:1568578300
Name:CHATWANI, SHITAL SHETH (OD)
Entity Type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:SHETH
Last Name:CHATWANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KING AVENUE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536
Mailing Address - Country:US
Mailing Address - Phone:510-713-0881
Mailing Address - Fax:
Practice Address - Street 1:7340 THORNTON AVENUE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560
Practice Address - Country:US
Practice Address - Phone:510-792-9611
Practice Address - Fax:510-792-9614
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11805152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management