Provider Demographics
NPI:1023472560
Name:SHAH, CHIRAG M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16766 BERNARDO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2545
Mailing Address - Country:US
Mailing Address - Phone:858-381-0686
Mailing Address - Fax:858-365-5189
Practice Address - Street 1:16766 BERNARDO CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2545
Practice Address - Country:US
Practice Address - Phone:858-381-0686
Practice Address - Fax:858-365-5189
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.153318207WX0107X
CAA155838207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist