Individual
MAMTA D SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(905) 558-4250
Mailing address
27431 SAN BERNARDINO AVE APT 263, REDLANDS, CA 92374-5087
(562) 584-3661
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
20A21088
CA
Other
Enumeration date
04/30/2020
Last updated
06/30/2023
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