Provider Demographics
NPI:1336333608
Name:SHAH, RUGMINI SATHIAPALAN (MD)
Entity Type:Individual
Prefix:
First Name:RUGMINI
Middle Name:SATHIAPALAN
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 1:9930 GRANITE PARK CT
Mailing Address - Street 2:1133 COLOMA WAY
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6759
Mailing Address - Country:US
Mailing Address - Phone:916-797-1751
Mailing Address - Fax:916-797-1753
Practice Address - Street 1:9930 GRANITE PARK CT
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-6759
Practice Address - Country:US
Practice Address - Phone:916-797-1751
Practice Address - Fax:916-797-1753
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0262692083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine