Provider Demographics
NPI:1861427213
Name:SHAH, AMAR (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51258
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-5558
Mailing Address - Country:US
Mailing Address - Phone:310-423-8780
Mailing Address - Fax:310-423-0424
Practice Address - Street 1:8700 BEVERLY BLVD STE 1110
Practice Address - Street 2:CEDARS - SINAI MED. CENTER DEPT. OF EMERGENCY MEDICINE
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-8780
Practice Address - Fax:310-423-0424
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-08-20
Deactivation Date:2006-07-19
Deactivation Code:
Reactivation Date:2006-11-08
Provider Licenses
StateLicense IDTaxonomies
CAA81087207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I14216Medicare UPIN
NY6F008EM771Medicare ID - Type Unspecified
NY02570836Medicaid