Provider Demographics
NPI:1487885067
Name:BINDLISH, SHAGUN (MD)
Entity type:Individual
Prefix:DR
First Name:SHAGUN
Middle Name:
Last Name:BINDLISH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:2337 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3506
Practice Address - Country:US
Practice Address - Phone:925-230-2386
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA240982207R00000X
OH35099976207R00000X
CAA132461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810026635Medicaid
OH0076915Medicaid
OH0076915Medicaid
WV3810026635Medicaid