Provider Demographics
NPI:1306835848
Name:ADVANI, SHARMEELA (MD)
Entity Type:Individual
Prefix:
First Name:SHARMEELA
Middle Name:
Last Name:ADVANI
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 1:20310 VIA BOTTICELLI
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4436
Mailing Address - Country:US
Mailing Address - Phone:818-886-3659
Mailing Address - Fax:
Practice Address - Street 1:1172 N MACLAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1328
Practice Address - Country:US
Practice Address - Phone:818-270-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2334221174400000X
CAA101674207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY789D81Medicare PIN
NYI35442Medicare UPIN