Shah Wellness Medical Clinic Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A36638 Issued in CA

Legal business name

SHAH WELLNESS MEDICAL CLINIC INC.

Practice address

23341 Golden Springs Dr
Suite 210
Diamond Bar, CA 91765-2058

Phone

(909) 860-2610

Fax

(909) 860-1192

NPI assigned

Dec 5, 2014

Last updated

Dec 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hitendra H Shah, M.D.NPI 1376614818

Title

President

Phone

(909) 860-2610

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, and the practitioner matching its NPPES authorized official.

• Hitendra H. Shah, M.D.

  • Family Medicine Physician
  • Diamond Bar, CA
  • NPI 1376614818
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1720486822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23341 GOLDEN SPRINGS DR",
            "address_2": "SUITE 210",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652058",
            "telephone_number": "909-860-2610",
            "fax_number": "909-860-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23341 GOLDEN SPRINGS DR",
            "address_2": "SUITE 210",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652058",
            "telephone_number": "909-860-2610",
            "fax_number": "909-860-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAH WELLNESS MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "HITENDRA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-860-2610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A36638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shahin Psychological Services, Inc.
• Shahin Psychological Services. Inc.

• General Practice Physician in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.