Provider Demographics
NPI:1639402704
Name:SHEVY, DRORA (MD)
Entity Type:Individual
Prefix:
First Name:DRORA
Middle Name:
Last Name:SHEVY
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 1:1840 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2145
Mailing Address - Country:US
Mailing Address - Phone:626-487-4536
Mailing Address - Fax:
Practice Address - Street 1:1840 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2145
Practice Address - Country:US
Practice Address - Phone:626-487-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80145208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice