# SHAH WELLNESS MEDICAL CLINIC INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720486822
- **Authorized official:** DR. HITENDRA H SHAH M.D. (PRESIDENT)
- **Authorized official phone:** (909) 860-2610

## Contact information

- **Practice address:** 23341 GOLDEN SPRINGS DR, SUITE 210, DIAMOND BAR, CA 91765-2058
- **Practice address phone:** (909) 860-2610
- **Practice address fax:** (909) 860-1192
- **Mailing address:** 23341 GOLDEN SPRINGS DR, SUITE 210, DIAMOND BAR, CA 91765-2058
- **Mailing address phone:** (909) 860-2610
- **Mailing address fax:** (909) 860-1192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A36638 | CA | Yes |

## Other

- **Enumeration date:** 12/05/2014
- **Last updated:** 12/05/2014