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Individual

MEENAL AMISH SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
447 W EATON AVE, TRACY, CA 95376-3420
(209) 830-4063
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A99476
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A99476
MEDICAL BOARD OF CALIFORN
CA
Enumeration date
06/08/2007
Last updated
07/10/2013
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