Prabhu RV Shankar, MD, MS

Individual provider Active NPI Internal Medicine Physician · El Macero, CA

NPI 1629928858 · NPPES record last updated Jan 28, 2026

Key facts

NPI
1629928858
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
78760 (AZ)
Practice address
44222 Greenview Dr
El Macero, CA 95618-1015
Phone
(408) 458-6119
NPI assigned
Jan 28, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
78760AZMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 78760 AZ Yes

Addresses

Primary practice location

44222 Greenview Dr
El Macero, CA 95618-1015

Mailing address

44222 Greenview Dr
El Macero, CA 95618-1015
Phone (408) 458-6119

Other providers in El Macero, CA

All providers in El Macero, CA · Internal Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.