Provider Demographics
NPI:1710024344
Name:ATUL S.SHETH, MD MED CORPORATION
Entity type:Organization
Organization Name:ATUL S.SHETH, MD MED CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-733-6000
Mailing Address - Street 1:755 S BERNARDO AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1022
Mailing Address - Country:US
Mailing Address - Phone:408-733-6000
Mailing Address - Fax:
Practice Address - Street 1:755 S BERNARDO AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1022
Practice Address - Country:US
Practice Address - Phone:408-733-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40513207VE0102X
CAC413852080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty