Individual
ANIL VALLABHDAS SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2621 S BRISTOL ST, #108, SANTA ANA, CA 92704-5718
(714) 754-1684
(714) 966-0417
Mailing address
2621 S BRISTOL ST, #108, SANTA ANA, CA 92704-5718
(714) 754-1684
(714) 966-0417
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A35578
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A35578
STATE MEDICAL LICENSE
CA
05
—
OOA355780
—
CA
Enumeration date
07/19/2006
Last updated
03/07/2023
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