Provider Demographics
NPI:1083741953
Name:SHIFFMAN, ANGELES (NP)
Entity Type:Individual
Prefix:
First Name:ANGELES
Middle Name:
Last Name:SHIFFMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12099 W WASHINGTON BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-2620
Mailing Address - Country:US
Mailing Address - Phone:310-398-3803
Mailing Address - Fax:310-398-5189
Practice Address - Street 1:12099 W WASHINGTON BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-2620
Practice Address - Country:US
Practice Address - Phone:310-398-3803
Practice Address - Fax:310-398-5189
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10288363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner