Basic Information
| Provider Information | |||||||||
| NPI: | 1932605094 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | AKASH | ||||||||
| MiddleName: | ATUL | ||||||||
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| Mailing Information | |||||||||
| Address1: | UCLA DEPARTMENT OF ORTHOPAEDIC SURGERY | ||||||||
| Address2: | 10833 LE CONTE AVENUE, 76-116 CHS | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90095 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | UCLA DEPARTMENT OF ORTHOPAEDIC SURGERY | ||||||||
| Address2: | 10833 LE CONTE AVENUE, 76-116 CHS | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108256557 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2018 | ||||||||
| LastUpdateDate: | 04/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.