# SAMIR A SHAH MD PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Beach Eye Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700197365
- **Authorized official:** DR. SAMIR SHAH MD (PHYSICIAN)
- **Authorized official phone:** (714) 965-9696

## Contact information

- **Practice address:** 18582 MAIN ST, HUNTINGTON BEACH, CA 92648-1701
- **Practice address phone:** (714) 965-9696
- **Practice address fax:** (714) 965-9797
- **Mailing address:** 18582 MAIN ST, HUNTINGTON BEACH, CA 92648-1701
- **Mailing address phone:** (714) 965-9696
- **Mailing address fax:** (714) 965-9797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | A85961 | CA | Yes |

## Other

- **Enumeration date:** 06/29/2010
- **Last updated:** 11/14/2023