Provider Demographics
NPI:1790965747
Name:SWAMY, SHYLA B (MD)
Entity Type:Individual
Prefix:
First Name:SHYLA
Middle Name:B
Last Name:SWAMY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:65 N MADISON AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2038
Mailing Address - Country:US
Mailing Address - Phone:626-397-8300
Mailing Address - Fax:626-397-8337
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2035
Practice Address - Country:US
Practice Address - Phone:626-792-3141
Practice Address - Fax:626-792-9193
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2020-05-21
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Provider Licenses
StateLicense IDTaxonomies
CAA99150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA99150OtherCALIFORNIA MEDICAL LICENS
CAWA99150BMedicare PIN
CAWA99150AMedicare PIN