| Rupal B, Shah, Md., Inc | |
|
770 Magnolia Ave Ste 1k Corona CA 92879-3122 | |
| (951) 738-0303 | |
| Not Available |
| Full Name | Rupal B, Shah, Md., Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 770 Magnolia Ave Ste 1k, Corona, California |
| Authorized Official Name and Position | Rupal B Shah (OWNER) |
| Authorized Official Contact | 9517350303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rupal B, Shah, Md., Inc 770 Magnolia Ave Ste 1k Corona CA 92879-3122 Ph: (951) 738-0303 | Rupal B, Shah, Md., Inc 770 Magnolia Ave Ste 1k Corona CA 92879-3122 Ph: (951) 738-0303 |
| NPI Number | 1144483611 |
|---|---|
| Provider Enumeration Date | 07/05/2008 |
| Last Update Date | 07/05/2008 |
| Medicare PECOS PAC ID | 0840349304 |
|---|---|
| Medicare Enrollment ID | O20090513000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144483611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A51553 (California) | Primary |
| Provider Name | Rupal B Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396730560 PECOS PAC ID: 5092864553 Enrollment ID: I20090521000143 |
| Provider Name | Stephanie Jamie Changchien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205061835 PECOS PAC ID: 0143413070 Enrollment ID: I20170403002504 |
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