Provider Demographics
NPI:1730446709
Name:SHAH, LINA SARTHI (MD)
Entity type:Individual
Prefix:DR
First Name:LINA
Middle Name:SARTHI
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 E GONZALES RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-8210
Mailing Address - Country:US
Mailing Address - Phone:805-981-5365
Mailing Address - Fax:805-658-4580
Practice Address - Street 1:2240 E GONZALES RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-8210
Practice Address - Country:US
Practice Address - Phone:805-981-5365
Practice Address - Fax:805-658-4580
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136716208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics