Provider Demographics
NPI:1578896247
Name:SHAINHOUSE, TSIPPORA (MD)
Entity Type:Individual
Prefix:DR
First Name:TSIPPORA
Middle Name:
Last Name:SHAINHOUSE
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 1:414 S LAS PALMAS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4816
Mailing Address - Country:US
Mailing Address - Phone:718-510-2419
Mailing Address - Fax:424-239-7050
Practice Address - Street 1:239 S LA CIENEGA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3319
Practice Address - Country:US
Practice Address - Phone:424-302-0394
Practice Address - Fax:424-239-7050
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82036208000000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics