Provider Demographics
NPI:1649429358
Name:SHINGATE, MANISHA NITIN (MD)
Entity type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:NITIN
Last Name:SHINGATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MANISHA
Other - Middle Name:MUKUND
Other - Last Name:KULKARNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS, DGO
Mailing Address - Street 1:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:5820 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3274
Practice Address - Country:US
Practice Address - Phone:925-224-0720
Practice Address - Fax:925-224-0722
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA142938Medicare PIN