DR. KETAN K SHAH (NPI# 1629244652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629244652 |
| Entity Type | Individual |
| Full Name | DR. KETAN K SHAH |
| Credential | M.D., M.B.A. |
| Practice Address |
24221 Calle De La Louisa Suite 300 Laguna Hills CA 92653-7638 |
| Mailing Address |
24221 Calle De La Louisa Suite 400 Laguna Hills CA 92653-7638 |
| Practice Telephone | 9497707163 |
| Practice Fax Number | 9494650946 |
| Mailing Telephone | 9494658155 |
| Mailing Fax Number | 9494658159 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2015-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A120437 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
A120437 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689959900 | Ketan Mahendra Shah | Nurse Practitioner | 422 N Prospect St, Wheaton, IL 60187-5839 | 2011-10-18 |
| 1407137102 | Ketan H Shah | Pharmacist | 153 Wood Ave, Edison, NJ 08820-3504 | 2011-09-08 |
| 1841306693 | Ketan Shah | Otolaryngology | 1000 Eleven S, Ste 4f, Columbia, IL 62236-1080 | 2006-08-22 |
| 1609822360 | Ketan D. Shah | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-05-25 |
| 1144575788 | Ketan Yogesh Shah | Internal Medicine | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2012-07-19 |
| 1922390210 | Ketan R Shah | Nurse Anesthetist, Certified Registered | 3200 Tyre Neck Rd, Suite 101, Portsmouth, VA 23703-3329 | 2011-05-05 |
| 1790001535 | Ketan Vikrambhai Shah | Internal Medicine | 300 Highland Ave, Hanover, PA 17331-2297 | 2010-04-19 |
| 1871507053 | Ketan Shah | Internal Medicine | 5500 Armstrong Rd, Battle Creek, MI 49015-1014 | 2006-07-27 |
| 1528098134 | Ketan Shah | Internal Medicine | 2211 E Franklin Blvd, Ste 100, Gastonia, NC 28054-4985 | 2006-07-03 |
| 1083664023 | Ketan S. Shah | Internal Medicine | 3120 Governors Place Blvd, Dayton, OH 45409-1328 | 2006-05-11 |
| Street Address |
24221 CALLE DE LA LOUISA SUITE 300 |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-7638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609845361 | Arthur J Daigneault | Internal Medicine | 24221 Calle De La Louisa, Suite 200, Laguna Hills, CA 92653-7638 | 2006-03-15 |
| 1104093277 | Nairi Asadoorian Berner | Internal Medicine | 24221 Calle De La Louisa, Suite 400, Laguna Hills, CA 92653-7638 | 2008-05-08 |
| 1558531129 | Catherine Bao Ngo | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2008-03-10 |
| 1366598591 | Tracy Ann Siegfried | Internal Medicine | 24221 Calle De La Louisa, Suite 400, Laguna Hills, CA 92653-7638 | 2007-01-29 |
| 1598826612 | Benjamin Menasheh Weinberg | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-12-12 |
| 1518056027 | Maziar Zamani | Internal Medicine | 24221 Calle De La Louisa, Suite 400, Laguna Hills, CA 92653-7638 | 2006-10-12 |
| 1497792147 | Nathaniel Dat Ho | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-06-01 |
| 1306883053 | Cuong Phu Ly | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-06-01 |
| 1821052598 | Louis S Scarcella | Internal Medicine | 24221 Calle De La Louisa, Suite 400, Laguna Hills, CA 92653-7638 | 2006-04-12 |
| 1619930567 | David E Hatoff | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063966299 | Dalia Ibrahim-abdelaziz Md | Internal Medicine | 24411 Health Center Dr Ste 430, Laguna Hills, CA 92653-3633 | 2016-08-04 |
| 1710244462 | Farid Jalali | Internal Medicine | 24221 Calle De La Louisa Ste 300, Laguna Hills, CA 92653-7637 | 2012-04-19 |
| 1326590902 | Prohealth Partners A Medical Group | Internal Medicine | 24411 Health Center Dr, Suite 430, Laguna Hills, CA 92653-3651 | 2016-10-28 |
| 1558531129 | Catherine Bao Ngo | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2008-03-10 |
| 1619930567 | David E Hatoff | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-04-11 |
| 1386605822 | Saddleback Medical Group Inc | Internal Medicine | 24221 Calle De La Louisa, Suite 400, Laguna Hills, CA 92653-7638 | 2006-03-31 |
| 1679534796 | Barry S Donner | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-03-29 |
| 1245209089 | James M Trenbeath | Internal Medicine | 24221 Calle De La Louisa, Suite 300, Laguna Hills, CA 92653-7638 | 2006-03-15 |
| 1144215880 | Rose T Codini | Internal Medicine | 24411 Health Center Dr, Suite # 430, Laguna Hills, CA 92653-3633 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1487252359 | Westside Gastroenterology and Hepatology | Internal Medicine | 2080 Century Park E Ste 1200, Los Angeles, CA 90067-2015 | 2020-10-13 |
| 1548883622 | Martha Hierro, Md Inc | Internal Medicine | 2021 Santa Monica Blvd Ste 335e, Santa Monica, CA 90404-2146 | 2020-05-22 |
| 1922629542 | Dieta Inc. | Internal Medicine | 15 Locust Ave, Oak Park, CA 91377-1115 | 2020-05-05 |
| 1861020364 | Kelvin Yeh Md Inc | Internal Medicine | 1715 S Date Ave, Alhambra, CA 91803-2908 | 2020-03-30 |
| 1598399917 | Indraneel Chakrabarty, Md Inc. | Internal Medicine | 31625 De Portola Rd Ste 101, Temecula, CA 92592-2770 | 2020-02-25 |
| 1316581390 | Premier Digestive Health A Medical Corporation | Internal Medicine | 16350 Ventura Blvd # D539, Encino, CA 91436-5300 | 2019-11-01 |
| 1427604834 | Adventist Health Physicians Network | Internal Medicine | 999 S Fairmont Ave Ste 50, Lodi, CA 95240-5139 | 2019-08-12 |
| 1861045106 | Gary M Van Deventer Md Inc | Internal Medicine | 504 W Pueblo St Ste 201, Santa Barbara, CA 93105-6211 | 2019-07-16 |
| 1689232779 | Zelman Weingarten Md Inc | Internal Medicine | 101 E Beverly Blvd Ste 203, Montebello, CA 90640-4315 | 2019-06-03 |
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| City | LAGUNA HILLS |
| Zip Code | 92653 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.