| Dr Praful C Shah, MD | |
|
1690 Barton Rd Ste 104, Redlands, CA 92373-4230 | |
| (909) 792-7309 | |
| (909) 796-4158 |
| Full Name | Dr Praful C Shah |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1690 Barton Rd Ste 104, Redlands, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730135880 | NPI | - | NPPES |
| 00A335100 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | A33510 (California) | Secondary |
| 208000000X | Pediatrics | A33510 (California) | Primary |
| Entity Name | Beaver Medical Group P C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649503319 PECOS PAC ID: 0547164295 Enrollment ID: O20031124000449 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Praful C Shah, MD Po Box 10069, San Bernardino, CA 92423-0069 Ph: (909) 335-4188 | Dr Praful C Shah, MD 1690 Barton Rd Ste 104, Redlands, CA 92373-4230 Ph: (909) 792-7309 |
Dr. Varonica Dixon, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1690 Barton Rd Ste 104, Redlands, CA 92373 Phone: 909-793-2896 Fax: 909-796-4158 | |
Dr. Ernesto Cruz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1684 Plum Ln, Suite 101, Redlands, CA 92374 Phone: 909-475-5800 Fax: 909-475-5805 | |
Dr. Julia Ann White, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1690 Barton Rd Ste 104, Redlands, CA 92373 Phone: 909-335-0200 | |
Mr. Seth Adam Cohen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1600 E Citrus Ave Ste A, Redlands, CA 92374 Phone: 909-794-3682 | |
Dr. Christopher Ng, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 26001 Redlands Blvd, Redlands, CA 92373 Phone: 909-825-7084 | |
Stephen Weerasit Hamra, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 245 Terracina Blvd Ste 208, Redlands, CA 92373 Phone: 909-307-0964 | |
Heather Marie Barr, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1690 Barton Rd Ste 104, Redlands, CA 92373 Phone: 909-335-0200 |