| Ketan Shah Md Inc | |
|
1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 | |
| (949) 744-5441 | |
| (949) 266-1661 |
| Full Name | Ketan Shah Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1100 W Town And Country Rd Ste 1250, Orange, California |
| Authorized Official Name and Position | Ketan K Shah (PRESIDENT) |
| Authorized Official Contact | 9497445441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketan Shah Md Inc 1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 Ph: (949) 744-5441 | Ketan Shah Md Inc 1100 W Town And Country Rd Ste 1250 Orange CA 92868-4633 Ph: (949) 744-5441 |
| NPI Number | 1952179350 |
|---|---|
| Provider Enumeration Date | 12/14/2023 |
| Last Update Date | 02/02/2024 |
| Medicare PECOS PAC ID | 0042653974 |
|---|---|
| Medicare Enrollment ID | O20240208000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952179350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Ketan K Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629244652 PECOS PAC ID: 3274847272 Enrollment ID: I20150804006312 |
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