Provider Demographics
NPI:1396851648
Name:SHETH, SHREYA S (MD)
Entity Type:Individual
Prefix:
First Name:SHREYA
Middle Name:S
Last Name:SHETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHREYA
Other - Middle Name:J
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8700 BEVERLY BLVD.
Mailing Address - Street 2:AHSP, A3600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1804
Mailing Address - Country:US
Mailing Address - Phone:310-423-1153
Mailing Address - Fax:310-423-6795
Practice Address - Street 1:8700 BEVERLY BLVD.
Practice Address - Street 2:AHSP, A3600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-1153
Practice Address - Fax:310-423-6795
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML20008691208000000X
CAA1085302080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics