Ketan Shah Md Inc | |
1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 | |
(949) 744-5441 | |
(949) 266-1661 |
Full Name | Ketan Shah Md Inc |
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Speciality | Internal Medicine |
Location | 1100 W Town And Country Rd Ste 1250, Orange, California |
Authorized Official Name and Position | Ketan K Shah (PRESIDENT) |
Authorized Official Contact | 9497445441 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Ketan Shah Md Inc 1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 Ph: (949) 744-5441 | Ketan Shah Md Inc 1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 Ph: (949) 744-5441 |
NPI Number | 1952179350 |
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Provider Enumeration Date | 12/14/2023 |
Last Update Date | 02/02/2024 |
Medicare PECOS PAC ID | 0042653974 |
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Medicare Enrollment ID | O20240208000305 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952179350 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Ketan K Shah |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1629244652 PECOS PAC ID: 3274847272 Enrollment ID: I20150804006312 |
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