Individual
PURVEE S SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
(916) 784-4050
Mailing address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A112540
CA
207KA0200X
Allergy Physician
4301090547
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2007
Last updated
12/07/2021
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