Individual
JANKI BHUVA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2020 SANTA MONICA BLVD, SUITE 220, SANTA MONICA, CA 90404-2023
(310) 582-6220
Mailing address
2020 SANTA MONICA BLVD, SUITE 220, SANTA MONICA, CA 90404-2023
(310) 582-6220
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A79229
CA
207RI0011X
Interventional Cardiology Physician
A79229
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497826325
—
CA
Enumeration date
11/13/2006
Last updated
09/17/2012
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