Provider Demographics
NPI:1144421082
Name:PATIL, SHILPA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:
Last Name:PATIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 N MISSION RD
Mailing Address - Street 2:RM L-919
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1019
Mailing Address - Country:US
Mailing Address - Phone:323-226-3406
Mailing Address - Fax:323-226-3440
Practice Address - Street 1:1240 N MISSION RD
Practice Address - Street 2:RM L-919
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1019
Practice Address - Country:US
Practice Address - Phone:323-226-3406
Practice Address - Fax:323-226-3440
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA845922080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine