Provider Demographics
NPI:1881629509
Name:EL-FARRA, NEVEEN SHAHER (MD)
Entity Type:Individual
Prefix:
First Name:NEVEEN
Middle Name:SHAHER
Last Name:EL-FARRA
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 1:757 WESTOWOOD PLZ
Mailing Address - Street 2:SUITE 7501
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-267-9643
Mailing Address - Fax:310-267-3840
Practice Address - Street 1:757 WESTOWOOD PLZ
Practice Address - Street 2:SUITE 7501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-267-9643
Practice Address - Fax:310-267-3840
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84756207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A847560Medicaid
CA00A847560Medicaid
CAI44649Medicare UPIN