Provider Demographics
NPI:1992935068
Name:MAHESH, SHOBHA RANI C (MD)
Entity type:Individual
Prefix:
First Name:SHOBHA RANI
Middle Name:C
Last Name:MAHESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHOBHA RANI
Other - Middle Name:
Other - Last Name:HOLALU CHOWDIAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26882 TOWNE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2862
Mailing Address - Country:US
Mailing Address - Phone:949-455-8559
Mailing Address - Fax:949-455-8561
Practice Address - Street 1:26882 TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2862
Practice Address - Country:US
Practice Address - Phone:949-455-8559
Practice Address - Fax:949-455-8561
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine