Provider Demographics
NPI:1811084197
Name:SHAH, HITESH ZAVERCHAND (MD)
Entity type:Individual
Prefix:DR
First Name:HITESH
Middle Name:ZAVERCHAND
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 STOCKDALE HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3653
Mailing Address - Country:US
Mailing Address - Phone:661-663-4444
Mailing Address - Fax:661-663-4100
Practice Address - Street 1:9802 STOCKDALE HWY STE 103
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3653
Practice Address - Country:US
Practice Address - Phone:661-663-4444
Practice Address - Fax:661-663-4100
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43422208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A4342201Medicaid