Provider Demographics
NPI:1730974098
Name:SHAH, SYED MUHAMMAD BEHRAM
Entity type:Individual
Prefix:
First Name:SYED MUHAMMAD BEHRAM
Middle Name:
Last Name:SHAH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 ASHFORD CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-7436
Mailing Address - Country:US
Mailing Address - Phone:714-251-4808
Mailing Address - Fax:
Practice Address - Street 1:934 ASHFORD CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-7436
Practice Address - Country:US
Practice Address - Phone:714-251-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies