Provider Demographics
NPI:1659510444
Name:SHAH, SONALI ASHOK (DO)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:ASHOK
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8041 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7034
Mailing Address - Country:US
Mailing Address - Phone:714-500-0226
Mailing Address - Fax:714-842-9843
Practice Address - Street 1:8041 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7034
Practice Address - Country:US
Practice Address - Phone:714-500-0226
Practice Address - Fax:714-842-9843
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10875207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology