Provider Demographics
NPI:1770508582
Name:DHEERIYA, UJJWALA SHAH (MD)
Entity Type:Individual
Prefix:DR
First Name:UJJWALA
Middle Name:SHAH
Last Name:DHEERIYA
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 1:2900 LOMITA BLVD.
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-377-2707
Mailing Address - Fax:310-377-2707
Practice Address - Street 1:2900 LOMITA BLVD.
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-784-8713
Practice Address - Fax:310-784-4991
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70781207RH0002X, 207R00000X
CAA71781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine