Provider Demographics
NPI:1881916864
Name:SHAH-PATEL, HEENA ANKIT (MD)
Entity type:Individual
Prefix:DR
First Name:HEENA
Middle Name:ANKIT
Last Name:SHAH-PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:HEENA
Other - Middle Name:HASMUKH
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1282 W ARROW HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5040
Mailing Address - Country:US
Mailing Address - Phone:909-931-4034
Mailing Address - Fax:909-931-2477
Practice Address - Street 1:1282 W ARROW HWY STE 100
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5040
Practice Address - Country:US
Practice Address - Phone:909-931-4034
Practice Address - Fax:909-931-2477
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118245207RA0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology