Provider Demographics
NPI:1639339641
Name:TILWALLI, SHILPA DHRUVA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:DHRUVA
Last Name:TILWALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7402 HOLLISTER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2583
Mailing Address - Country:US
Mailing Address - Phone:805-562-8686
Mailing Address - Fax:805-456-1796
Practice Address - Street 1:7402 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93117-2583
Practice Address - Country:US
Practice Address - Phone:703-675-1375
Practice Address - Fax:805-456-1796
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65080-202084N0400X
IL036.1188142084N0400X
IL0361188142084N0400X
MI43011194172084N0400X
NJ25MA094575002084N0400X
CAC558892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118814OtherPHYSICIAN LICENSE
IL336.080059OtherCONTROLLED SUBSTANCE
MI4301119417OtherBOARD OF MEDICINE
CAC55889OtherTHE MEDICAL BOARD OF CALIFORNIA