Provider Demographics
NPI:1376555862
Name:BAGAI LAPSI, SHELLY N (MD)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:N
Last Name:BAGAI LAPSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:BAGAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:554 E SAN BERNARDINO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1748
Mailing Address - Country:US
Mailing Address - Phone:206-354-2604
Mailing Address - Fax:
Practice Address - Street 1:554 E SAN BERNARDINO RD
Practice Address - Street 2:SUITE 102
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1748
Practice Address - Country:US
Practice Address - Phone:206-354-2604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20008550207R00000X, 207W00000X
CAA114121207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine