Avani Patel Shah MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AVANI PATEL SHAH MD INC

Practice address

5632 Philadelphia St Ste 201
Chino, CA 91710-8702

Phone

(909) 660-8585

Fax

(909) 660-8652

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Avani Patel Shah, MD

Title

Owner

Phone

(909) 912-2979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Avani Manilal Patel, M.D.

  • Internal Medicine Physician
  • Chino, CA
  • NPI 1154360998
  Medicare reassignment NPD

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1487477600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1682 N ROCKY RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917842501",
            "telephone_number": "909-912-2979",
            "fax_number": "909-660-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 PHILADELPHIA ST STE 201",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917108702",
            "telephone_number": "909-660-8585",
            "fax_number": "909-660-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANI PATEL SHAH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "PATEL SHAH",
        "authorized_official_first_name": "AVANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-912-2979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Chino, CA
• Providers in Chino, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.