Provider Demographics
NPI:1215946504
Name:SHAH, BHAVIESH RASIKLAL (MD)
Entity type:Individual
Prefix:DR
First Name:BHAVIESH
Middle Name:RASIKLAL
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11401 BLOOMFIELD AVE
Mailing Address - Street 2:METROPOLITAN STATE HOSPITAL
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2015
Mailing Address - Country:US
Mailing Address - Phone:562-651-5475
Mailing Address - Fax:951-736-9449
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:METROPOLITAN STATE HOSPITAL
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-651-5475
Practice Address - Fax:951-736-9449
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-12-06
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Provider Licenses
StateLicense IDTaxonomies
CAA63424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine