Basic Information
| Provider Information | |||||||||
| NPI: | 1083733117 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAKHEE N. SHAH, MD, A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5575 W LAS POSITAS BLVD | ||||||||
| Address2: | 270 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945885801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254603883 | ||||||||
| FaxNumber: | 9254603859 | ||||||||
| Practice Location | |||||||||
| Address1: | 5575 W LAS POSITAS BLVD | ||||||||
| Address2: | 270 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945885801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254603883 | ||||||||
| FaxNumber: | 9254603859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PUNCHES | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9254603883 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | A90744 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
No ID Information.