Provider Demographics
NPI:1043761166
Name:IGOR GARY SHLIFER DO P.C.
Entity Type:Organization
Organization Name:IGOR GARY SHLIFER DO P.C.
Other - Org Name:EVOLVE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SHLIFER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-346-4300
Mailing Address - Street 1:20301 VENTURA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2447
Mailing Address - Country:US
Mailing Address - Phone:818-981-0080
Mailing Address - Fax:
Practice Address - Street 1:20301 VENTURA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2447
Practice Address - Country:US
Practice Address - Phone:818-981-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14715261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty