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Individual

JAY BAKUL SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C145834
CA
208800000X
Urology Physician
N0452
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202822701
TX
01
8V1995
BCBS
TX
01
P00830874
RR MEDICARE
TX
Enumeration date
04/14/2009
Last updated
03/14/2024
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