Provider Demographics
NPI:1083193072
Name:MELEKH-SHALOM, SHEILA RACHEL
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:RACHEL
Last Name:MELEKH-SHALOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6807
Mailing Address - Country:US
Mailing Address - Phone:310-909-0180
Mailing Address - Fax:
Practice Address - Street 1:2125 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1337
Practice Address - Country:US
Practice Address - Phone:310-829-8701
Practice Address - Fax:310-477-7281
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3322231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist