Shah, Smita Jayprakash

Shah, Smita Jayprakash is an sole proprietor health care provider with primary practice located at 1805 Medical Center Dr , San Bernardino CA 92411-1217. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Shah, Smita Jayprakash can be contacted via phone (909) 887-6333.

Contact Information

Primary practice address
1805 Medical Center Dr San Bernardino CA 92411-1217
Phone: (909) 887-6333
Fax: (909) 887-9565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A40709 California

Profile Details

NPI number 1255349379
LBN Legal business name Shah, Smita Jayprakash
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2006
Last updated Sep 10th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255349379 NPPES
California MEDICAID 00A407090
California Other 00A407090

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