Individual
MEDHA SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25845 BARTON RD STE 101, LOMA LINDA, CA 92354-5300
(909) 558-3904
Mailing address
11175 CAMPUS ST RM A1111, LOMA LINDA, CA 92350-1700
(909) 558-8142
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
A162944
CA
Other
Enumeration date
04/04/2016
Last updated
09/13/2022
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