Dr. Kunal T. Shah O.D. Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

12356T Issued in CA

Legal business name

DR. KUNAL T. SHAH O.D. INC.

Practice address

17139 Bellflower Blvd
# 101
Bellflower, CA 90706-5943

Phone

(562) 866-2020

Fax

(562) 920-3336

NPI assigned

Dec 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kunal T. Shah, O.D.NPI 1528172616

Title

Owner / President

Phone

(562) 866-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kunal Tushar Shah, O.D.

  • Optometrist
  • Bellflower, CA
  • NPI 1528172616
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1275802662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17139 BELLFLOWER BLVD",
            "address_2": "# 101",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065943",
            "telephone_number": "562-866-2020",
            "fax_number": "562-920-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17139 BELLFLOWER BLVD",
            "address_2": "# 101",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065943",
            "telephone_number": "562-866-2020",
            "fax_number": "562-920-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KUNAL T. SHAH O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KUNAL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "562-866-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12356T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275802662",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.