Provider Demographics
NPI:1982483624
Name:KAIRAV SHAH MD PC
Entity Type:Organization
Organization Name:KAIRAV SHAH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAIRAV
Authorized Official - Middle Name:RAMESHCHANDRA
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-222-4338
Mailing Address - Street 1:1741 CAMPANULA DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5155
Mailing Address - Country:US
Mailing Address - Phone:925-222-4338
Mailing Address - Fax:
Practice Address - Street 1:4695 CHABOT DR STE 200
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2756
Practice Address - Country:US
Practice Address - Phone:925-222-4338
Practice Address - Fax:925-222-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty