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Individual

AMISH KISHOR SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O., M.P,H,

Contact information

Practice address
17542 17TH ST, SUITE 320, TUSTIN, CA 92780-1959
(714) 734-5500
Mailing address
17542 17TH ST, SUITE 320, TUSTIN, CA 92780-1959
(714) 734-5500

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
20A11673
CA

Other

Enumeration date
03/05/2009
Last updated
11/29/2021
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