Provider Demographics
NPI:1932187945
Name:SHAH, NIMISHA H (MD)
Entity Type:Individual
Prefix:DR
First Name:NIMISHA
Middle Name:H
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18550 DE PAUL DR
Mailing Address - Street 2:SUITE # 101 DE PAUL HEALTH CENTER
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2911
Mailing Address - Country:US
Mailing Address - Phone:408-776-3900
Mailing Address - Fax:408-776-3919
Practice Address - Street 1:18550 DE PAUL DR
Practice Address - Street 2:SUITE # 101 DE PAUL HEALTH CENTER
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2911
Practice Address - Country:US
Practice Address - Phone:408-776-3900
Practice Address - Fax:408-776-3919
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84372207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG58957Medicare UPIN
CA00A843720Medicare ID - Type Unspecified