Basic Information
| Provider Information | |||||||||
| NPI: | 1083622138 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | SHEFALI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 DATA DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956707956 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3000 Q ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958167058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167333400 | ||||||||
| FaxNumber: | 9167335940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 12/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A89282 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2506548 | 01 | CA | UNITED HEALTHCARE | OTHER | 108698 | 01 | CA | HEALTH NET | OTHER | 4749332 | 01 | CA | CIGNA | OTHER | A89282 | 01 | CA | BLUE CROSS | OTHER | 90144717 | 01 | CA | PACIFICARE | OTHER | 000810659543 | 01 | CA | PHCS | OTHER | 1838807 | 01 | CA | GREAT WEST | OTHER | MCMG383900 | 01 | CA | WESTERN HEALTH ADVANTAGE | OTHER | 248466 | 01 | CA | INTERPLAN | OTHER | 5594383 | 01 | CA | FIRST HEALTH | OTHER | 7281628 | 01 | CA | AETNA | OTHER |